This position is responsible for supporting the functions of compiling, analyzing, trending, tracking and interpretation of data collected related to the pharmacy and Medicare divisions. In addition the Financial Analyst – Pharmacy & Medicare Level 1 will support report development, benchmarking and other financial reporting activities that contribute to corporate reporting objectives, business solutions and recommendations. This position will interact with other departments as required and will assist the Financial Analysts Levels 1 and 2, Financial & Data Analyst Team Lead and the Manager of Financial and Data Analytics in the performance of their assigned job functions.
- Support the compiling, analyzing, and interpretation of data collected related to the pharmacy and Medicare divisions. Identify opportunities for improvement based on basic data analysis.
- Support the analysts in performing basic reporting and reconciliation of data for the pharmacy and Medicare divisions.
- Support the delivery of basic analytical reporting to internal departments as well as for external entities and activities related to the pharmacy and Medicare division:
- Support the reporting on current/future processes related to the analysis of pharmacy costs, utilization measurements, and benchmarks
- Support the reporting on current/future processes related to drug cost savings, formulary changes, and pharmacy rebates
- Support the role of entering Pharmacy contracts, EFT and daily pharmacy updates
- Responsible as back up to Pharmacy-Medicare Analyst Team Lead and Financial Analyst – Pharmacy & Medicare Levels 2 and 3 and the Manager of Financial and Data Analytics in daily activities and tasks
- Support the function of basic internal reporting and trending, including monthly drug spend, fraud waste and abuse findings, and corporate dashboards
- Support the function of Bi-weekly/weekly pharmacy claims payment and invoice reconciliation
- Train on appropriate software applications to be able to identify and produce custom reports from administrative databases. Support the role of extracting data, perform appropriate verification, format, print, and distribute reports to internal and external customers including graphical representations of data as needed.
- Support the development of basic ad-hoc reports as needed.
- Support the performance of data quality control functions; audit of all data reports prior to placement in production data base.
- Support the development of policy documentation of procedures in all areas.
- Perform other duties as assigned.
High school diploma is required. Pursuit of a Bachelor’s degree or Fellow designation from the Academy for Healthcare Management (AHM) is preferred. Experience in managed care, quality management or health care data information systems and data analysis, with at least two years in a managed care setting. Experience in using PC-based software packages, spreadsheets and word processing. Experience working on team projects in the health care industry. Knowledge of managed care principles and procedures. Knowledge of drug terminology and therapeutic classes. Knowledge of Medicaid, Medicare, and Pharmacy Benefit Management.
Meridian Health Plan - 18 months ago
OmniCare Health Plan strives to care for everyone, or at least everyone in the southeast Michigan area. The company provides health...