Senior Pharmacy Compliance Reporting Analyst

This is a fully remote position, open to applicants in Connecticut, +2 more states.

📋 Description

• Evaluate, identify, and mitigate risks related to regulatory compliance

• Collaborate with various departments to develop, implement, and monitor compliance strategies for Pharmacy Operations

• Assist the Director of Pharmacy Operations in ensuring that PBM and delegated pharmacy vendors comply with federal and state regulations

• Conduct monthly member identification for the Medication Therapy Management program and support its regulatory components and reporting

• Maintain the integrity of operational data while creating program insights and analytical tools

• Improve and automate compliance reporting solutions, encompassing data collection, validation, aggregation, governance, and reporting processes

• Develop analytical capabilities for risk detection, profiling, and mitigation using advanced statistical methods

• Identify and recruit enrollees for the monthly MTM program

• Assist with MTM outreach data requests and assess claims monitoring for approvals, rejections, and timeliness

• Oversee the language, content, and timeliness of communications to enrollees, providers, and pharmacies to ensure regulatory compliance

• Coordinate with internal stakeholders and PBM on matters concerning non-binary gender identities

• Act on behalf of the department for Transparency in Coverage Rule inquiries and obligations

• Engage in both internal and external audits

• Provide ad-hoc reporting solutions to pinpoint compliance and operational inefficiencies

⛳️ Requirements

• Bachelor's degree in computer science, information science, electrical engineering, or a related discipline

• 5 years of experience in data management and analytics within managed care operations or as a pharmacy benefit manager

• 5 years of experience in gathering, analyzing, and conveying complex analytical business requirements to a variety of technical and non-technical stakeholders

• 5 years of experience in developing and utilizing reports and dashboards to assess and measure product performance

• 5 years of experience with Base SAS, SAS EG, Tableau, Aginity Workbench, SQL Server, and Management Studio

• 5 years of experience conducting advanced statistical analysis, creating interactive visualizations, managing databases, automating processes, and ensuring data integrity

• 5 years of experience managing multiple concurrent projects for Finance, Benefits, Utilization Management, Regulatory and Compliance, and Specialty Pharmacy teams

• 5 years of experience writing scalable, maintainable, well-documented, and supportable code

• Applicants must fulfill all minimum requirements

🏝️ Benefits

• Medical, dental, and vision coverage

• Incentive and recognition programs

• Life insurance

• 401k contributions

• Competitive compensation and benefits package