Pharmacy Operations Specialist

7 days ago


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

The Pharmacy Quality Initiatives Analyst I will be responsible for providing analytical support for pharmacy operations, trending of pharmacy quality initiatives, 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
  1. Establish query and analysis of outcomes reporting for clinical pharmacy metrics to provide Pharmacy Key Performance Indicators (KPI) for various utilization reports.
  2. Provide analytical support for pharmacy operations through the creation of standard reports and the development of new reports when necessary to meet business needs.
  3. Develop and maintain various dashboards used by the clinical team to support pharmacy quality interventions.
  4. 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.
  5. Assist with analyses on pharmacy utilization patterns, clinical program impact modeling (STARS/HEDIS), and other clinical reports in collaboration with a pharmacist.
  6. 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.
  7. Support all other pharmacy data analytics, financial management, utilization management, and reporting needs (both intra- and interdepartmental).
  8. Perform other duties as assigned.
Requirements
  • Bachelor's Degree in STEM or Related Field
  • At least 3-5 years of prior experience as an analyst within either a managed-care organization, health plan, or Pharmacy Benefit Manager (PBM) setting
  • Prior experience with modeling and analyzing data to interpret outcomes and results
  • Proficiency with querying data and designing relational tables in databases
  • Proficiency and experience with SQL, VBA, SAS, R, and/or other equivalent programming languages
  • Advanced knowledge and proficiency in Microsoft Applications including Access, Excel, and Word
  • Ability to communicate with others through verbal and written communication to interpret and translate requests into business needs
  • Ability to clearly document scope and business requirements in a clear and concise manner
  • Effective decision making/problem solving and critical thinking skills
  • Ability to demonstrate strong analytical and logical approaches to develop solutions through prior projects and experiences


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