Business Analytics Associate
Core
Review and resolve pharmacy inquiries related to Non-MAC pricing, validate pricing data using trusted sources, and respond to state regulatory inquiries.
Role type
Associate, pharmacy benefit management compliance
Builds
Pricing compliance resolutions and regulatory responses for pharmacy members
Domain
Healthcare / Pharmacy Benefit Management
Deliverable
dashboards & analysis
Required skills
Pharmacy Benefit Management (PBM) processes, Non-MAC appeal processes, claims adjudication logic, AS400 (RxClaim platform)
Preferred skills
Excel, Salesforce, mathematical problem-solving
Technologies
AS400, Medispan, Salesforce, Pharmacy Portal
Responsibilities
Review and resolve pharmacy inquiries related to Non-MAC pricing; Validate pricing and product information using trusted sources; Identify changes in marketplace conditions and escalate issues; Assist Non-MAC team contractors with questions and training; Monitor and perform testing activities related to IT system implementations; Research and respond to Department of Insurance inquiries.
Seniority
Associate, individual contributor
