Senior Pharmacy Analyst
About The Position
As a Senior Pharmacy Analyst at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Your role in our mission involves working under the supervision of the Pharmacy Benefit Manager within the Bureau of Clinical Policy and Pharmacy, serving as an embedded resource on the pharmacy team. The pharmacy section develops and implements drug coverage and reimbursement policies for outpatient drugs. This position collaborates with a team of policy analysts, systems analysts, and clinical staff. The primary responsibility is for the assessment, monitoring, and ongoing maintenance of the drug reference file, which includes items covered under the pharmacy benefit and physician-administered drugs. You will serve primarily as an information and data analyst for the drug reference file and be responsible for the evaluation and ongoing management needed for accurate maintenance of the drug reference file and its functionality within Wisconsin’s Medicaid Management Information System (MMIS). Ongoing activities include, but are not limited to, drug file data maintenance, analysis, research, and published data table maintenance. Long-term activities include analyzing proposed changes to the drug reference file, developing alternatives, and proposing initiatives to improve the quality and efficiencies of the drug reference file.
Requirements
- 6 or more years of experience as a Business Analyst in Healthcare / Pharmacy Industry
- 3 or more years of Medicaid and Medicare experience
- Experience in Pharmacy reimbursement and understanding of drug coverage rules
- Experience as a systems business analyst
- Understanding of National drug codes (NDC)
- Experience with drug claims processes
Nice To Haves
- Access database and Medicaid Pharmacy Benefit experience
Responsibilities
- Assessment, monitoring, and ongoing maintenance of the drug reference file
- Serving as an information and data analyst for the drug reference file
- Evaluation and ongoing management for accurate maintenance of the drug reference file and its functionality within Wisconsin’s Medicaid Management Information System (MMIS)
- Drug file data maintenance, analysis, research, and published data table maintenance
- Analyzing proposed changes to the drug reference file, developing alternatives, and proposing initiatives to improve the quality and efficiencies of the drug reference file
Benefits
- Flexible vacation policy
- 401(k) employer match
- Comprehensive health benefits
- Educational assistance
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
No Education Listed
