Pharmacy Information Analyst I

3 weeks ago

Los Angeles, California, United States L.A. Care Health Plan Full time

Salary Range: $77, Min.) - $100, Mid.) - $123, Max.)

Established in 1997, L.A. Care Health Plan is an independent public agency created by the state of California to provide health coverage to low-income Los Angeles County residents. We are the nation's largest publicly operated health plan. Serving more than 2 million members, we make sure our members get the right care at the right place at the right time.

Mission: L.A. Care's mission is to provide access to quality health care for Los Angeles County's vulnerable and low-income communities and residents and to support the safety net required to achieve that purpose.

Job Summary

The Pharmacy Information Analyst I will be responsible for the following: providing analytical support for pharmacy operations, financial trending of pharmacy utilization, creating and maintaining databases as needed for reporting needs, identifying opportunities for process improvement and providing solutions, and supporting various business functions as needed within the Pharmacy & Formulary Department.

Duties

Establish query and analysis of outcomes reporting for clinical and financial pharmacy metrics to provide Pharmacy Key Performance Indicators (KPI) for various utilization reports. Provide analytical support for pharmacy operations through the creation of standard reports and the development of new reports when necessary to meet business needs.

Develop/assist with development of pharmacy financial trend reports in various capacities including but not limited to: forecasting reports of utilization for actuarial modeling, modeling of high cost/specialty drug trends, modeling to identify the impact of various trends (drug inflation/utilization/member demographics).

Provide analytical support through the maintenance and enhancement of existing databases as well as the development of new databases to meet operational and clinical initiative needs.

Review and validate pharmacy cycle payment reports per Line of Business to ensure accurate financial invoices from the Pharmacy Benefit Manager vendor.

Assist with analyses on pharmacy utilization patterns, clinical program impact modeling (STARS/HEDIS), therapeutic drug category trends, and other clinical reports in collaboration with a pharmacist.

Engage all relevant participants regarding new reporting needs, particularly during workgroup sessions to gather information from requests in order to accurately interpret and translate true end requirements necessary to meet business needs.

Support all other pharmacy data analytics, financial management, utilization management, and reporting needs (both intra- and interdepartmental).

Perform other duties as assigned.


Duties Continued
Education Required
Bachelor's DegreeIn lieu of degree, equivalent education and/or experience may be considered.Education Preferred
Master's DegreeExperience

Required:

At least 3 years of prior experience as an analyst.

Prior experience with modeling and analyzing data to interpret outcomes and results.

Preferred:

Knowledge of and experience with relational databases (e.g., Oracle, SQL server).

At least 3 years of project and/or data analysis experience in Managed Care Organization, PBM or health plan

Skills

Required:

Proficiency with querying data and designing relational tables in databases.

Proficiency and experience with SQL, VBA, SAS, R, and/or other equivalent programming languages.

Must have a thorough understanding of how to apply excel functions and utilize SQL or other languages to perform modeling and analysis when provided with project scope and criteria.

Advanced knowledge and proficiency in Microsoft Applications including Access, Excel, and Word.

Possess the ability to communicate with others through verbal and written communication to interpret and translate requests into business needs.

Must be able to clearly document scope and business requirements in a clear and concise manner.

Must have effective decision making/problem solving and critical thinking skills.

Must possess the ability to demonstrate strong analytical and logical approaches to develop solutions through prior projects and experiences.

Preferred:

Basic working knowledge of managed care principles and/or pharmacy operations within a healthcare system.

Licenses/Certifications Required
Licenses/Certifications Preferred
Required Training
Physical Requirements
LightAdditional Information

Salary Range Disclaimer: The expected pay range is based on many factors such as geography, experience, education, and the market. The range is subject to change.

L.A. Care offers a wide range of benefits including

  • Paid Time Off (PTO)
  • Tuition Reimbursement
  • Retirement Plans
  • Medical, Dental and Vision
  • Wellness Program
  • Volunteer Time Off (VTO)

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