PBM Senior Analyst, Underwriting

SlateRx•Las Vegas, NV

6d•Remote

About The Position

As the Senior Analyst you will play a crucial role in supporting the Director of Underwriting with the increasing demands of financial arrangements and repricing. Your responsibilities will include conducting financial analyses, supporting RFP processes, executing repricing exercises, analyzing value propositions, and monitoring contract compliance. Collaborating closely with cross-functional teams, you will contribute to enhancing member health outcomes and driving the growth of our organization.

Requirements

Proficient in collecting and extracting relevant data from various sources, including pharmacy insurance claims databases. Skilled in utilizing data analysis tools and techniques to identify trends, patterns, and insights that contribute to informed decision-making.
Ability to assess and quantify risk factors associated with PBM contracts and pricing strategies. Proficiency in identifying potential financial risks and proposing mitigation strategies.
Strong aptitude for building complex financial models to simulate different scenarios, pricing structures, and underwriting outcomes. Expertise in using modeling software and spreadsheet applications for accurate financial projections.
In-depth understanding of the intricate details and terminology commonly found in PBM contracts. Proficient in reviewing, interpreting, and negotiating contract terms to optimize financial outcomes and minimize potential liabilities.
Familiarity with statistical methods and techniques for evaluating data significance and drawing meaningful conclusions. Capable of performing statistical analyses to support underwriting decisions and pricing strategies.
Excellent verbal and written communication skills with the ability to convey complex financial concepts and analysis results in a clear and understandable manner. Comfortable presenting findings to internal teams, clients, or stakeholders.
Keen attention to detail when working with financial data, contracts, and documentation. Ensures accuracy and precision in all aspects of underwriting and financial analysis.
Strong problem-solving abilities, capable of identifying issues, analyzing root causes, and proposing effective solutions. Adaptable in addressing challenges and making data-driven recommendations.
Awareness of regulatory requirements and industry standards related to PBM operations and healthcare finance. Ensures that underwriting practices align with applicable laws and regulations.
Effective teamwork and collaboration skills to work closely with cross-functional teams, including clinical, implementation, and account teams. Capable of integrating financial insights into broader strategic initiatives.
A commitment to staying updated with industry trends, emerging technologies, and best practices in PBM underwriting and financial analysis. Willingness to pursue relevant certifications or professional development opportunities.
4+ years of previous experience in pharmacy benefit management/administration, with a specific functional background in data analytics and claims data.
Knowledge of reporting, data analytics, and problem solving using analytical tools such as Excel, SAS, SQL, Power BI, and/or other ad hoc Query Tools.

Nice To Haves

master’s degree a plus

Responsibilities

Assist in the completion of financial questionnaires for RFP processes.
Conduct repricing exercises and retrospective analyses of deal performance for clients and their advisors.
Analyze the value proposition for prospective clients.
Complete repricing and related requests as needed.
Conduct in-depth financial analysis to compare relative value between different deal structures.
Evaluate client ROI or opportunities arising from SlateRx programs.
Provide expert responses to complex questions from internal resources, including implementation and account teams.
Produce gross to net cost comparisons to guide decision-making.
Collaborate with the clinical team to develop therapeutic class or category-based financial scorecards for future strategic planning.
Address other financial inquiries originating from SlateRx administration and analytics teams.
Provide oversight and training to team members who have been delegated underwriting projects.
Understand and adjust variables in repricing data to adhere to RFP and company requirements.
Participate in development and implementation of initiatives, as needed, to improve processes and procedures.
Quantify the impact of various benefit designs on client utilization and costs.
Perform miscellaneous job-related duties as assigned.