Pharmacy Medical Informatics Analyst, Principal
1 week ago
The Pharmacy Medical Informaticist, Principal will play a crucial part in supporting the Pharmacy Reimagined strategy and traditional actuarial functions at Blue Shield of California. This role reports to the Senior Director, Cost of Health Care Actuarial, and involves collaborating with the Pharmacy Team to achieve strategic objectives in contract negotiations, pricing for self-funded employer groups, formulary changes, product development, and initiative evaluation.
Your Responsibilities
In this role, you will:
- Develop analytical systems that meet important business needs, leveraging your deep understanding of underlying business requirements.
- Design and develop systems that can be used by lower-level analysts, promoting company-wide efficiencies.
- Coordinate activities with other internal departments to maximize overall efficiency and resolve conflicts.
- Communicate project status, progress, and outcomes to executive management.
- Fulfill a leadership role in the critical review and ongoing development of data management and analytical systems for strategically important enterprise-wide analysis and reporting.
- Support vendor financial contract performance evaluation, forecast, and negotiation.
- Support the development of budget/trend impact models and formulary strategy models for high-impact existing and pipeline drugs.
- Provide Rx data support and participate in product governance/value assessment committee on Rx benefit and formulary strategy.
- Support ASO product strategy evaluation and coordinate with UW and Actuarial Trend teams as needed.
- Support RxCare strategic initiatives evaluation as needed.
Qualifications
To be successful in this role, you will require:
- An MPH, MBA, MS, MA, RN, or RHIA in health science, quantitative social science, public health, health services research, or business, or a BA/BS with demonstrated equivalent work experience.
- SAS Certified Base Programmer Credential or equivalent and SAS Certified Advanced Programmer Credential or equivalent.
- At least 10 years of prior relevant experience.
- At least 5 years of experience in Health Care (managed care, academic, or gov't payer).
- Experience at a Pharmacy Benefit Manager (PBM).
About Blue Shield of California
Blue Shield of California's mission is to ensure all Californians have access to high-quality health care at a sustainably affordable price. We are transforming health care in a way that genuinely serves our nonprofit mission by lowering costs, improving quality, and enhancing the member and physician experience. We strive to create a diverse, equitable, and inclusive environment where all employees can be their authentic selves and fully contribute to meet the needs of the multifaceted communities we serve.
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