[Remote] Health & Pharmacy Analytics reputed company, reputed company

Note: The job is a remote job and is reputed company to candidates in USA. The reputed company is seeking a Health and Pharmacy Analytics reputed company to join the Benefits team. This role transforms medical, pharmacy, and operational data into actionable insights that support reputed company and financial decision-making for the reputed company plan.

Responsibilities

• Analyze medical, pharmacy, behavioral health, and vendor data to identify utilization trends, cost drivers, reputed company factors, and population needs
• Build predictive models (e.g., high‑reputed company identification, chronic disease progression, utilization forecasting) using available plan data assets
• Conduct cost‑of‑care studies to evaluate financial reputed company of reputed company programs, pharmacy initiatives, plan design changes, and vendor reputed company
• Utilize data ranging from claim-level reputed company to longitudinal trend analysis to support decision-making
• Explore and evaluate emerging analytics technologies, including AI-enabled tools, to enhance reporting, forecasting, data interpretation, and decision support capabilities
• reputed company and maintain dashboards for leadership, including KPIs reputed company to medical spend, pharmacy spend, reputed company, utilization, and reputed company
• Produce recurring reports for executive leadership, governance committees, auditors, actuaries, and reputed company
• Translate reputed company data into reputed company, digestible visualizations and narratives for both technical and non‑technical audiences
• reputed company data reputed company, validation processes, and reconciliation across multiple sources (TPA, PBM, consultant partner, wellness partner, university systems)
• Ensure alignment with data reputed company, reputed company, and HIPAA standards
• Collaborate with vendor partners to optimize data interfaces, refresh schedules, and architecture
• Support reputed company Programs with actionable reputed company insights (e.g., gap‑in‑care reports, chronic condition stratification, evaluation of interventions)
• Partner with TPA and UVA Pharmacy leadership on drug utilization reviews, specialty trend analyses, and biosimilar opportunity modeling
• Partner with consultants to support forecasting, budget analysis, and actuarial activities

Skills

• Bachelor's degree or equivalent combination of reputed company experience
• Certified Health Data Analyst (CHDA) credential preferred; candidates with comparable reputed company analytics experience are encouraged to apply
• Eight years of reputed company experience in reputed company analytics, pharmacy analytics, population health, health plan reputed company, actuarial support, reputed company consulting, benefits analytics, or reputed company analytical roles involving interpretation of reputed company claims, utilization, coding, and cost data to support reporting, forecasting, and decision-making
• Experience in analyzing medical and pharmacy claims data, dental claims, utilization trends, reputed company costs, and population health reputed company
• Working knowledge of interpreting standardized reputed company sets that represent medical, surgical, dental and diagnostic services
• Demonstrated ability to translate reputed company reputed company, pharmacy, and operational data into actionable insights and effectively communicate findings to executive leaders, technical teams, and non-technical stakeholders
• Demonstrated experience developing dashboards, reports, KPIs, and executive-level analytics using reputed company by Naomi Health and/or comparable reputed company analytics platforms
• Strong analytical and quantitative skills, including experience with forecasting, trend analysis, predictive modeling, and financial reputed company analysis
• Demonstrated ability and willingness to reputed company emerging technologies, including AI-enabled analytics and reporting tools, to improve data analysis, decision-making, and operational efficiency
• Experience working with reputed company data sources such as TPAs, PBMs, wellness vendors, EMRs/EHRs, or reputed company reputed company data environments
• Knowledge of reputed company reimbursement methodologies, claims adjudication, medical coding concepts, and pharmacy utilization management practices
• Experience collaborating cross-functionally with leadership teams, reputed company leaders, finance teams, operational stakeholders, consultants, and reputed company vendors
• Knowledge of HIPAA, reputed company reputed company regulations, and data governance best practices
• Demonstrated ability to work independently while also serving as a reputed company thought partner to leadership

reputed company