Pharmacy Pricing and Analytics, Sr. Principal

2 weeks ago

Denver, CO, United States Blue Shield of CA Full time

Your Role

The Pharmacy Analytics & Finance team is responsible for supporting the Pharmacy Reimagined strategy in addition to traditional actuarial functions of claim reserves and cost trends. The Pharmacy Medical Informaticist, Senior Principal will report to the Senior Director, Actuarial Management and support the Pharmacy Team's strategic objectives in contract negotiations, pricing for self-funded employer groups, formulary changes, product development, and initiative evaluation.

Your Knowledge and Experience

  • Requires a BA/BS in Finance, Actuarial, Data Science, Mathematics or related field with demonstrated equivalent work experience
  • Requires a minimum of 10 years of prior relevant experience
  • Requires 5 years' experience in Health Care (managed care, academic, or gov't payer) or with a Pharmacy Benefit Manager (PBM) or Pharmacy benefit consulting houses
  • Requires data analytics tool expertise for both SAS and excel
  • Requires expertise in pharmacy benefit manager operations and pricing
  • Requires expertise in pharmacy rebate and network dynamics to enable financial and pricing modeling
  • Requires strong verbal and communication skills
  • Prefer candidates to have an MPH, MBA, MS, MA, RN, or RHIA in health science, quantitative social science, public health, health services research or business.
  • Requires understanding of a dynamic environment in the pharmacy space given the strategic move away from relying on pharmacy benefit managers to modular solution and away from pharmacy rebates to "net cost" approaches
  • Requires expert knowledge in PowerPoint, Word, Excel with strong verbal communication and collaboration skills

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