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Milliman · 2 weeks ago

Pharmacy Benefits Analytics Manager (CMH Health)

Brookfield, WI

Full-time

Hybrid

Mid, Senior Level

$135K/yr - $223K/yr

4+ years exp

Milliman is an independent consulting firm that delivers market-leading services and solutions to clients worldwide. The Pharmacy Benefits Analytics Manager will diagnose client problems, develop project proposals, and manage internal resources while presenting results to clients in the healthcare sector.

AnalyticsConsultingInsurTech

No H1B

Responsibilities

Provide qualitative and financial evaluations of PBM contracts, including pricing and fee schedules

Assist with developing models to conduct detailed analyses of pharmacy data, including pharmacy claims, eligibility data, etc

Acquire, standardize, and merge various data sets to provide summarized reports

Contribute to drafting proposals, presentations, exhibits, RFPs, and reports

Manage client relationships, projects, assignments, presentations, and deliverables

Be able to work independently, but also actively lead teams utilizing pharmacy data expertise on various projects

Trend Related Modeling and Analysis

Analyzing pharmacy data to provide innovative pricing solutions

Medicare Part D, Medicaid, and Commercial Pharmacy Formulary and Pricing Analysis

Medicare Part D Fraud, Waste, and Abuse Monitoring

Evaluation of New Product Pipeline (e.g., evaluating impact of agents for NASH, oncology drugs, etc.)

Pharmaceutical Company Strategy Support (e.g., analytics to support formulary negotiations and modeling)

Qualification

Pharmacy industry experiencePharmacy claims reimbursementData analysis technologiesModel creationMicrosoft ExcelAnalytical thinkingCreative problem solvingVerbal communicationWritten communicationClient focusedTeamworkSelf-motivated

Required

Individual(s) must be legally authorized to work in the United States without the need for immigration support or sponsorship from Milliman now or in the future

Bachelor's degree required

A minimum of four years of experience in the pharmacy industry (ex. PBM, health plan, retail pharmacy etc.)

Extensive knowledge of pharmacy claims reimbursement (ex. WAC, AWP, discounts, rebates, etc.)

Experience with handling large pharmacy claims datasets

Experience creating models and reports focused on opportunities for formulary management, prior authorizations, drug pricing, etc

Strong business software capabilities, especially with Microsoft office tools (Excel) and data analysis technologies (SAS/SQL)

Analytical thinking and the ability to evaluate analyses for downstream impact

Creative problem solving and analytical skills

Superior verbal and written communication skills

Client focused and results oriented

Ability to work independently and in a team environment

Self-motivated, creative, and resourceful

Preferred

It is preferred that candidates work on-site at our Brookfield, WI, Chicago, IL, or Hartford, CT office, however, remote candidates will be considered

Benefits

Medical, Dental and Vision – Coverage for employees, dependents, and domestic partners.

Employee Assistance Program (EAP) – Confidential support for personal and work-related challenges.

401(k) Plan – Includes a company matching program and profit-sharing contributions.

Discretionary Bonus Program – Recognizing employee contributions.

Flexible Spending Accounts (FSA) – Pre-tax savings for dependent care, transportation, and eligible medical expenses.

Paid Time Off (PTO) – Begins accruing on the first day of work. Full-time employees accrue 15 days per year, and employees working less than full-time accrue PTO on a prorated basis.

Holidays – A minimum of 10 observed holidays per year.

Family Building Benefits – Includes adoption and fertility assistance.

Paid Parental Leave – Up to 12 weeks of paid leave for employees who meet eligibility criteria.

Life Insurance & AD&D – 100% of premiums covered by Milliman.

Short-Term and Long-Term Disability – Fully paid by Milliman.