Pharmacy Analyst

Highmark Health•Pittsburgh, PA

26d•Hybrid

About The Position

This role involves working with Pharmacy Markets business owners and stakeholders to achieve growth objectives. The Pharmacy Analyst will organize and coordinate activities, monitor progress, and perform corrective actions as needed. They will communicate effectively with customers regarding issues and concerns. Responsibilities may include performing research, managing projects of various sizes, analyzing data to identify business problems and trends, and developing innovative Pharmacy products. The role also requires partnering with business units to ensure compliance with regulations and policies, monitoring regulatory changes, and providing consultation and analytic support. Additionally, the analyst will collaborate with business owners to understand needs, translate them into requirements and functional designs, and analyze change requests for existing applications.

Requirements

High school diploma / GED
Healthcare experience
Project Management experience
Advanced experience with MS Office.
Experience in performing group/meeting presentations to technical/non-technical and customer audiences.
Strong critical thinking skills.
Ability to identify and assess patterns, trends, root causes, develop explanations and test solutions.
Ability to identify and assess problems and solutions, refer to applicable policies, identify options, and recommend appropriate courses of action.
Excellent verbal and written communication skills.

Nice To Haves

Bachelor's Degree
Project Management
Critical analysis and problem resolution skills
Six-Sigma

Responsibilities

Perform research on projects and manage and lead projects to successfully meet business objectives.
Analyze data to determine business problem, trends, or opportunities for process improvements.
Identify needs to develop new and innovative Pharmacy products, perform appropriate research/analyses, and evaluate feasibility of the administration and implementation of products.
Partner with business units to ensure compliance with governmental, contractual, and corporate guidelines, regulations, and policies and procedures.
Continuously monitor regulatory changes, legislative efforts, industry trends, and/or contract changes.
Provide consultation and analytic support to assigned functional areas.
Collaborate with business owners/stakeholders to understand business needs, processes project specifications and business case development.
Translate business needs into clearly defined and documented, high quality requirements, functional designs, and system supplemental specifications for new Pharmacy Markets applications and/or analyzes change requests/enhancements in existing Pharmacy Markets applications.
Implement product/program designs and ensure quality standards, financial performance, and regulations are met.
Develop and establish standardized processes and effective measurement, evaluation and improvement methods.
Implement interventions that result in continuous measurable improvements.
Work collaboratively with business owners to identify areas where improvements are needed and to develop and monitor appropriate action plans to ensure a consistent focus on priority issues.
Analyze data processes, business processes, and interfaces to support multiple areas which will include program (and/or vendor) oversight, using appropriate measurement processes and potential audits.
Gather and analyze information, designs and test solutions to problems and formulates plans.
Make decisions that refine and improve known practices or develops new approaches.
Work with multidisciplinary teams within Pharmacy Markets, other Highmark departments, and external vendors to ensure program effectiveness and general project management.
Make independent contributions to projects as well as contributes and manages some small to medium projects, when applicable.
Accountability for escalated or complex issue resolution.
Develop business and pharmacy benefit solutions to satisfy mutually agreed upon goals and objectives.
Conduct problem solving resolution and decision making sessions for complex issues and projects.
Promote a culture of performance excellence and continuous quality improvement.
Communicate effectively with all levels of the organization.
Establish routine informational exchanges, based upon proposed product designs, prospective goal setting, strategic planning and implementation activities.
Identify and articulate problems to management, steering committees and/or project sponsors.
Research and develop competitive pharmacy benefit offerings and ensure proper positioning in the marketplace.
Focus on achieving optimal member experience and continued viability of the pharmacy product portfolio.
Other duties as assigned or requested.