Pharmacy Analyst

JOB SUMMARY

The Pharmacy Analyst works with the Pharmacy Market business owners, stakeholders, and other management and supports the Specialty Pharmacy Products and Programs by performing critical analytical work and assisting with day-to-day departmental activities to achieve growth objectives, organizing and coordinating activities to ensure successful delivery of desired results. This role is instrumental in ensuring the end-to-end effectiveness, integrity, and quality of Highmark's specialty programs across both pharmacy and medical drug benefits.

ESSENTIAL RESPONSIBILITIES

• Investigating product and program inquiries, ensuring adherence to standard operation procedures, mandates, and quality benchmark standards, analyzing variances, and conducting comprehensive program audits, including focused audits documenting variances, deviations and nonconformances within programs when product or process changes occur.
• Monitoring and evaluating progress, status, and alignment of activities, with the ability to initiate corrective action as needed to maintain work viability and timeliness and monitoring the effectiveness of these actions.
• Communicate regularly and effectively with customers regarding issues or concerns.
• Responsible for research, project leadership and data analysis to identify business problems or process improvement opportunities and evaluating the feasibility of new Pharmacy products.
• Partnering with business units to ensure compliance with governmental, contractual, and corporate guidelines, continuously monitoring regulatory changes, and providing consultation and analytic support to assigned functional areas.
• Collaboration with business owners/stakeholders to translate business needs into clearly defined requirements, functional designs, and system specifications for new applications or change requests is also a core function.
• Analyzing data to identify improvement opportunities

PREFERRED RESPONSIBILITIES

EDUCATION

Required

• High school diploma / GED

Substitutions

• None

Preferred

• Bachelor's Degree (technical or science preferred)

EXPERIENCE

Required

• Healthcare experience
• Project Management experience

Preferred

• Project Management
• Technical proficiency in Excel
• Analytical and problem-solving abilities
• Technical proficiency in SQL
• Experience with data visualization tools like Tableau or Power BI.
• Experience in a quality control or quality assurance role.

LICENSES or CERTIFICATIONS

Required

• None

Preferred

• Six-Sigma

SKILLS

• 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.

Language (Other than English):

None

Travel Requirement:

0% - 25%

PHYSICAL, MENTAL DEMANDS and WORKING CONDITIONS

Position Type

Office-based

Teaches / trains others regularly

Occasionally

Travel regularly from the office to various work sites or from site-to-site

Rarely

Works primarily out-of-the office selling products/services (sales employees)

Never

Physical work site required

Yes

Lifting: up to 10 pounds

Constantly

Lifting: 10 to 25 pounds

Occasionally

Lifting: 25 to 50 pounds

Rarely

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.
As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

Pay Range Maximum:

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.  The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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