Medication Use and Management Analyst

This is a fully remote position, open to applicants in Colorado, +1 more state.

📋 Description

• Gather and evaluate clinical medication and medication-related information from EPIC EMR, MedWise, PBM, medical claims, and financial data.

• Assess pharmacy medication claims for potential fraud, waste, and abuse, including instances of overcharging, over-dispensing, and inefficient utilization.

• Integrate various data sources to present clinical quality and performance metrics to senior leadership.

• Create and implement analyses that support clinical quality enhancement, care management, and utilization management.

• Assist in medication-use initiatives by collecting, consolidating, tracking performance, targeting interventions, and driving improvements.

• Conduct concurrent reviews and detailed retrospective analyses of patient records and medication claims.

• Design, sustain, and enhance KPI dashboards for senior management's use.

• Produce data analyses and reports for senior leadership, clinical personnel, and quality staff.

• Convey findings verbally, in written form, and visually to both subject matter experts and general audiences.

• Act as a content authority across the organization on measurement and analytical methodologies.

• Provide guidance to senior leaders and quality staff on data collection, research implications, and opportunities for data-driven improvements.

• Collaborate with clinical leadership, quality staff, Risk Management, Compliance, Clinical teams, IT Data Analytics, and Clinical Applications.

• Lead stakeholder discussions, identify unmet needs, advise on trends, and coordinate teams focused on process improvement.

⛳️ Requirements

• A bachelor's degree in research, statistics, health administration, or a related field from an accredited institution, or equivalent professional experience.

• At least 3 years of experience in data analysis.

• A minimum of 3 years of experience in generating and ensuring the accuracy of easily interpretable data analyses and presenting findings orally, in writing, or visually.

• Familiarity with medication quality measures, clinical performance, and financial metrics in the healthcare industry.

• Experience in obtaining and manipulating healthcare data, including medication claims and clinical values.

• Preferably experienced with EPIC Slicer/Dicer and Clarity data programs.

• Proficient in MS Office applications, including Teams, Word, Excel, and PowerPoint is preferred.

• Advanced skills in Tableau, Excel, SQL, and other database systems are preferred.

• Experience in constructing and utilizing pivot tables, advanced formulas, VBA, and macros is preferred.

• Ability to foster and maintain cooperative and positive working relationships.

• Highly organized, detail-oriented, diplomatic, proactive, self-motivated, reliable, and committed to excellence.

• Capable of managing multiple tasks amidst changing deadlines and priorities in a dynamic environment.

• Ability to work sensitively and effectively with individuals from diverse ethnic and cultural backgrounds.

• Florida applicants are required to undergo background screening through the Florida Care Provider Background Screening Clearinghouse.

🏝️ Benefits

• Medical insurance.

• Dental insurance.

• Vision insurance.

• Short- and long-term disability insurance.

• Life insurance and AD&D.

• Supplemental life insurance.

• Flexible spending accounts.

• 401(k) savings plan.

• 401(k) plan with company match.

• Paid time off.

• Company-paid holidays.

• Equal opportunity and affirmative action workplace.

• Patient-centered care model.

• Opportunities to collaborate with talented, respectful, and passionate colleagues.