Pharmacy Pricing Business Analyst
- Job Title
- Pharmacy Pricing Business Analyst
- Job ID
- 27656102
- Location
- Remote,
- Other Location
- Description
-
Pharmacy Pricing Business Analyst
OVERVIEW:
RxSense is a privately held health technology company whose mission is to make prescription drugs more affordable for everyone. We build technology platforms and data solutions that enable our customers to manage pharmacy benefits on behalf of their members, employees, or clients (e.g., health plans, employers, health systems, etc). RxSense also provides prescription benefit solutions directly to millions of people through its consumer brand, SingleCare. We have saved our customers over $4B on prescription medications since 2015.
Headquartered in Boston, MA, the company has experienced double-digit growth every year since its inception in 2015. The company has been recognized by Forbes as a Top Startup in 2020 and 2021 and recognized as one of Fast Company's Most Innovative Companies. Our team members have come from some of the country's most innovative and successful companies in healthcare and technology and together we have created a culture of opportunity, innovation, accountability, and trust. We are working together to solve big problems and create value in an industry that is personal for everyone - healthcare.
JOB SUMMARY:
RxSense is a forward-thinking, growth-oriented healthcare services and technology company that provides state-of-the-art pharmacy solutions. The Pharmacy Pricing Business Analyst in the Enterprise Platform Services division will report to the VP of Finance Administration and will be responsible for implementing, maintaining, and managing pricing for clients and pharmacies in RxAgile, the adjudication platform of RxSense. This critical role bridges the technology platform and finance (pricing) and will provide the Business Analyst an opportunity to assist in implementing and managing contract positions for the company.
PRIMARY JOB DUTIES & RESPONSIBILITIES:- Implement client and pharmacy pricing in RxAgile as directed by the VP of Finance Administration to include contracted rates and MACs
- Maintain and manage pricing in RxAgile post-implementation of client contracts to ensure contract objectives are achieved
- Maintain and manage pricing in RxAgile for pharmacy contracts to ensure contract compliance objectives are achieved
- Collaborate and coordinate with network management, benefits management, and other departments to build, implement and manage pricing in the adjudication platform for clients and pharmacies
- Analyze claim activity and produce reporting to show client and pharmacy contract objectives have been achieved
- Enhance and manage QA and claim testing process to ensure contract compliance and objectives
- Support the annual budget process as needed
- Be a subject matter expert for all things related to RxAgile pricing
- Conduct special projects as assigned
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform these essential functions.- Excellent working knowledge of pharmacy benefit administration
- Proficient ability to own the success of projects with minimal supervision using sound judgment, while maintaining a professional and positive demeanor
- Must be able to develop and maintain strong working relationships on a multi-level basis
- Superior written and verbal communication skills - ability to communicate information & ideas clearly & concisely
- Ability to foster a positive and creative work environment
- Ability to work in a dynamic fast-paced atmosphere
- Ability to maintain confidentiality
- Ability to work under tight deadlines
- Bachelor’s degree, emphasis in Accounting, Finance, Business Administration, or a technical degree with strong work experience related to finance. Technology background with an MBA would be ideal.
- Minimum of 5 years of pharmaceutical distribution and/or pharmacy benefits industry experience strongly preferred
- Strong business acumen, analytical skills, written and oral communication skills
- Highly proficient in Microsoft; Excel, Word, and PowerPoint
- Strong preference for an individual with data warehouse, SQL, and other data mining experience
The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.- Regularly required to sit and talk or hear and operate equipment. Frequently required to stand and walk.
- Regularly required to lift and/or move up to 15 pounds.
- Ability to stand for long periods of time and walk short distances.
- The noise level in the work environment is moderate. Personal Protective Equipment may be recommended and/or required in some areas.
- Travel required is less than 15%.