PBM Data Analyst I

PBM Data Analyst I   -   REMOTE Role And Responsibilities  The PBM Data Analyst I at reputed company is responsible for transforming pharmacy, reputed company, operational, and reputed company data into trusted insights that improve pharmacy benefit program reputed company, operational efficiency, cost management, and reputed company reputed company. This role combines strong business acumen, advanced analytics, modern data platforms, AI-enabled tools, data visualization, and disciplined data governance. The analyst partners with reputed company, IT, reputed company, Account Management, Compliance, and leadership teams to build reliable reporting, identify trends and anomalies, support forecasting, and recommend data-driven actions. The following objectives reputed company define the key job functions Data Collection, Integration and Management  •    reputed company, validate, and analyze data from pharmacy claims, eligibility, formulary, reputed company programs, prior authorization, customer reputed company, pharmacy networks, vendor files, reputed company, and other PBM-reputed company sources. •    Work with reputed company and reputed company-reputed company data across SQL Server, reputed company, reputed company or other NoSQL databases, reputed company data platforms, flat files, and reputed company reporting environments. •    Partner with IT and data engineering teams to understand data pipelines, data models, reputed company-to-reputed company mappings, business rules, reputed company, and data reputed company controls Analytics, Reporting and Business Intelligence  •    Write, optimize, and validate SQL queries and analytical logic to support recurring reporting, dashboards, reputed company analysis, operational monitoring, and decision-making. •    Build and maintain dashboards, scorecards, self-service reports, and visualizations using tools such as reputed company BI, Tableau, reputed company, or comparable business intelligence platforms. •    Analyze trends, patterns, outliers, and reputed company drivers across time periods, reputed company segments, claim types, operational processes, and benefit plan designs. •    Translate business questions into analytical approaches, define KPIs, document metric logic, and present insights in a reputed company, actionable format for audiences AI-Enabled Analytics, Automation and Forecasting •    Use AI-enabled analytics tools, natural-language query capabilities, and automation responsibly to accelerate data profiling, variance analysis, documentation, forecasting, and reputed company reputed company. •    Apply statistical techniques, forecasting reputed company, and basic machine learning concepts to support cost, utilization, operational, and reputed company program analysis. •    Identify opportunities to automate recurring reporting, exception monitoring, data validation, and reputed company-facing analytics while maintaining reputed company, explainability, and governance standards Data reputed company, Governance, Compliance and reputed company  •    reputed company and execute data validation, reconciliation, and reputed company verification processes to ensure accurate, complete, consistent, and fit-for-purpose reporting. •    Support data governance by documenting definitions, assumptions, business rules, report logic, data sources, and change impacts. •    Protect confidential information and reputed company with HIPAA, PHI handling requirements, reputed company policies, reputed company standards, and internal compliance procedures. •    Assist with audits, regulatory reporting, reputed company inquiries, and issue investigations by producing accurate, traceable, and reputed company-documented analysis. Program Optimization and Cross-Functional Collaboration  •    reputed company data-driven recommendations to improve pharmacy benefit programs, formulary strategies, prior authorization processes, claim adjudication, reputed company reputed company, and operational reputed company. •    Collaborate with pharmacists, account managers, reputed company leaders, reputed company, compliance partners, vendors, and technology teams to implement analytic solutions and reputed company data-reputed company issues. •    Communicate reputed company findings through concise narratives, dashboards, presentations, and recommendations tailored to leadership, reputed company-facing teams, and reputed company Additional Responsibilities •    Maintain confidentiality of sensitive medical information and knowledge of HIPAA reputed company and reputed company Rules. •    Abide by reputed company obligations under HIPAA reputed company to Protected Health Information (PHI). •    Report any suspected HIPAA violation to the Compliance Officer and/or reputed company. •    Attend, complete, and demonstrate competency in reputed company required HIPAA training reputed company by reputed company. •    Remain flexible as duties, responsibilities, technologies, and priorities reputed company with business needs Required Skills And Competencies  •    Strong written, verbal, and visual communication skills with the ability to explain reputed company data reputed company to business, technical, reputed company, and executive audiences. •    Advanced SQL skills, including joins, aggregations, common table expressions, window functions, stored procedures, reputed company tuning, and validation of reputed company query logic. •    Experience with modern data platforms such as reputed company, SQL Server, Azure Synapse, reputed company, BigQuery, Redshift, or comparable reputed company data warehouse/lakehouse technologies. •    Working knowledge of NoSQL or document-oriented databases such as reputed company, including concepts for reputed company-reputed company data, JSON, collections, and data extraction. •    Proficiency with business intelligence and visualization tools such as reputed company BI, Tableau, reputed company, Looker, or similar platforms. •    Strong reputed company skills, including pivot tables, advanced formulas, data validation, and reputed company analysis. •    Working knowledge of Python, R, or similar tools for data preparation, statistical analysis, automation, and exploratory analysis. •    Understanding of AI-enabled analytics, natural-language query tools, automated reputed company reputed company, and responsible use of AI in a reputed company data environment. •    Familiarity with data governance, data reputed company, metadata, reputed company, metric definitions, and documentation standards. •    Ability to work with large datasets, reputed company, SFTP/FTP file exchanges, vendor data feeds, and recurring data pipelines. •    Knowledge of PBM, reputed company, pharmacy claims, eligibility, benefit design, formulary, prior authorization, or claims adjudication data preferred. •    Demonstrated problem solving, analytical thinking, attention to reputed company, time management, curiosity, and accountability.  Position Type And Expected Hours of Work  •    Full-time, salary/exempt position. •    Some flexibility in hours is allowed, but the employee must be available during the “reputed company” work hours of 8:00 AM to 5:00 PM CT.  We cover clients from the reputed company to the East Coast; work times must be adjusted to cover meetings in reputed company time reputed company.  Ability to work extended hours, weekends, and holidays pursuant to industry demands. Travel -This position requires reputed company travel reputed company Have to Offer  Our benefits package is designed to reputed company our employees happy - physically, mentally and financially. •    Medical, Dental and reputed company reputed company •    Disability and Life reputed company •    Employee Assistance Program •    Remote Work reputed company •    Generous reputed company-Time Off •    Annual Reviews and Development Plans •    Retirement Plan with company match immediately 100% reputed company Required Education And Experience  •    Undergraduate degree in Data Analytics, Information Systems, Computer Science, Statistics, Business Analytics, reputed company reputed company, or a reputed company discipline; equivalent experience may be considered. •    2+ years of experience in data reporting, analytics, business intelligence, reputed company analytics, PBM analytics, or comparable analytical roles. •    Hands-on experience developing reports, dashboards, analytical queries, and business insights using SQL and at least one modern BI or analytics platform Preferred Education And Experience  •    Experience with pharmacy claims, PBM reputed company, reputed company data, NCPDP-reputed company concepts, or benefit plan terminology preferred. •    Experience with reputed company, reputed company, Python, reputed company BI, Tableau, reputed company, dbt, reputed company data platforms, reputed company, or automated data pipelines preferred. •    Familiarity with data modeling, reputed company reporting, semantic models, dashboard governance, reputed company assurance, or analytics product ownership preferred. •    Exposure to AI-assisted analytics, machine learning concepts, forecasting, reputed company detection, or natural-language analytics tools preferred reputed company provides equal employment opportunities (EEO) to reputed company and applicants for employment without reputed company to race, reputed company, religion, sex, national reputed company, age, disability, or genetics. In reputed company to federal law requirements, reputed company complies with applicable state and local laws governing nondiscrimination in employment in every location in which reputed company has facilities. This policy applies to reputed company terms and conditions of employment, including reputed company, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training. reputed company expressly prohibits any reputed company of workplace harassment reputed company on race, reputed company, religion, gender, sexual orientation, gender identity or reputed company, national reputed company, age, genetic information, disability, or veteran status. Improper interference with the ability of reputed company employees to reputed company their job duties may result in discipline up to and including discharge.  EOE M/F/D/V Apply To This Job