Pharmacy Business Analyst

Summa Western Reserve Hospital•Akron, OH

70d•$34 - $51•Hybrid

About The Position

As a regional, provider-owned health plan, SummaCare values the relationship between the members and their doctors. SummaCare is a part of Summa Health, an integrated healthcare delivery system that includes Summa Health System hospitals, its community-based health centers, dedicated clinicians and SummaCare. Based in Akron, Ohio, SummaCare provides Medicare Advantage, individual and family and commercial insurance plans. SummaCare has one of the highest rated Medicare Advantage plans in the state of Ohio, with a 4.5 out of 5-Star rating for 2025 by the Centers for Medicare and Medicaid Services (CMS). Known for its excellent customer service and personalized attention to members, SummaCare is committed to building lasting relationships. Employees can expect competitive pay and benefits. Summary: Provides project and business analysis support for basic to moderately complex requests related to SummaCare and its Pharmacy Benefit Manager ("PBM").

Requirements

Bachelor's degree or equivalent combination of education and/or experience.
One (1) year of similar or relevant experience such as working in a health plan or in a Pharmacy Benefit Manager (PBM) role.
Demonstrate excellent verbal and written communication skills.
Make sound decisions and recommendations based on consideration of facts, priorities, resources, and alternatives.
Effectively utilize MS Word, Excel, and other software applications to perform job duties.
Organize and manage time to accurately complete tasks within designated time frames in fast-paced environment.
Maintain current knowledge of and comply with regulatory and company policies & procedures.
Maintain confidentiality of member health information and business information.
Flexible: ability to adjust work hours to meet business demands.

Responsibilities

Provides support for pharmacy-related project management and business analysis requests including, but not limited to, data gathering and analysis, flowcharting of current process and procedures, creating project definition and scope, developing recommendations, implementing action plans, completing testing, and conducting quality assurance reviews.
Designs, develops, and maintains pharmacy benefit reporting tools.
Communicates, coordinates, and works with SummaCare and PBM Information Technology staff in resolving and completing Projects and System Requests that involve multiple departments.
Designs, builds, tests and implements new pharmacy benefits with the Pharmacy Benefits Manager (PBM) as well as tasks related to year end.
Communicates, coordinates and works with internal departments including Eligibility, Sales, Compliance Training, and Finance, to ensure successful implementation of new pharmacy benefits.
Coordinates, tracks and monitors financials related to pharmacy, including PBM Performance Guarantees and Rebates
Monitors and coordinates Medicare Prescription Drug Event (PDE) activities for the health plan.
Serves as Subject Matter Expert (SME) for the Pharmacy Management Team.
Performs all job functions with integrity. Provides timely internal and external customer service in cooperative, professional, and respectful manner.