Pharmacy Benefits Analytics Manager (CMH Health)

Milliman•Brookfield, WI

1d•$117,500 - $222,985•Hybrid

About The Position

Milliman’s CMH Health practice is seeking a Pharmacy Benefits Analytics Manager to work in a fast-growing area of the Health practice. This role will involve accurately diagnosing client problems, developing project proposals, refining project strategy, outlining a project plan, managing internal resources, and presenting the results to the client. The Pharmacy Benefits Analytics Manager may assist clients such as employers, health plans, PBMs, and pharmaceutical companies. Who We Are Independent for 75 years, Milliman delivers market-leading services and solutions to clients worldwide. Today, we are helping companies take on some of the world’s most critical and complex issues, including retirement funding and healthcare financing, risk management and regulatory compliance, data analytics and business transformation.

Requirements

Individual(s) must be legally authorized to work in the United States without the need for immigration support or sponsorship from Milliman now or in the future.
Bachelor’s degree required
A minimum of four years of experience in the pharmacy industry (ex. PBM, health plan, retail pharmacy etc.)
Extensive knowledge of pharmacy claims reimbursement (ex. WAC, AWP, discounts, rebates, etc.)
Experience with handling large pharmacy claims datasets
Experience creating models and reports focused on opportunities for formulary management, prior authorizations, drug pricing, etc.
Strong business software capabilities, especially with Microsoft office tools (Excel) and data analysis technologies (SAS/SQL)
Analytical thinking and the ability to evaluate analyses for downstream impact
Creative problem solving and analytical skills.
Superior verbal and written communication skills
Client focused and results oriented
Ability to work independently and in a team environment
Self-motivated, creative, and resourceful

Responsibilities

Provide qualitative and financial evaluations of PBM contracts, including pricing and fee schedules
Assist with developing models to conduct detailed analyses of pharmacy data, including pharmacy claims, eligibility data, etc.
Acquire, standardize, and merge various data sets to provide summarized reports
Contribute to drafting proposals, presentations, exhibits, RFPs, and reports
Manage client relationships, projects, assignments, presentations, and deliverables
Be able to work independently, but also actively lead teams utilizing pharmacy data expertise on various projects
Potential projects could include Trend Related Modeling and Analysis
Analyzing pharmacy data to provide innovative pricing solutions
Medicare Part D, Medicaid, and Commercial Pharmacy Formulary and Pricing Analysis
Medicare Part D Fraud, Waste, and Abuse Monitoring
Evaluation of New Product Pipeline (e.g., evaluating impact of agents for NASH, oncology drugs, etc.)
Pharmaceutical Company Strategy Support (e.g., analytics to support formulary negotiations and modeling)

Benefits

Medical, Dental and Vision – Coverage for employees, dependents, and domestic partners.
Employee Assistance Program (EAP) – Confidential support for personal and work-related challenges.
401(k) Plan – Includes a company matching program and profit-sharing contributions.
Discretionary Bonus Program – Recognizing employee contributions.
Flexible Spending Accounts (FSA) – Pre-tax savings for dependent care, transportation, and eligible medical expenses.
Paid Time Off (PTO) – Begins accruing on the first day of work. Full-time employees accrue 15 days per year, and employees working less than full-time accrue PTO on a prorated basis.
Holidays – A minimum of 10 observed holidays per year.
Family Building Benefits – Includes adoption and fertility assistance.
Paid Parental Leave – Up to 12 weeks of paid leave for employees who meet eligibility criteria.
Life Insurance & AD&D – 100% of premiums covered by Milliman.
Short-Term and Long-Term Disability – Fully paid by Milliman.