SUMMARY The primary purpose of this position is to obtain and/or provide, analyze or evaluate data in support of the Managed Care, Pharmacy Operations and/or Pharmacy Finance Departments. These projects support the financial and operational decisions of the Rite Aid Pharmacy departments. Frequent independent judgements are essential.
ESSENTIAL DUTIES AND RESPONSIBILITIES The associate is responsible for the functions below, in addition to other duties as assigned:
- Create and provide standardized trend and exception reports on a weekly, monthly and quarterly basis on metrics related to the management of the pharmacy business.
- Pull and maintain data on agency contract compliance on a quarterly basis to identify and investigate areas of non-compliance and communicate with management.
- Analyze Actual to Plan financial performance by Managed Care Agency and Payer to be provided to the Pharmacy Services Finance team.
- Analyze agency payments for brand and generic products as well as maintain the agency MAC list.
- Analyze, recommend and monitor tools for the Pharmacy retail Pricing team to maximize Third Party reimbursement without disruption to our cash customers.
- Support special projects that impact Managed Care, Pharmacy Operations or Pharmacy Services including savings card, speciality, delivery, 340B, etc.
- Audit and reconcile payer claims data against internal claims data to ensure proper prescription payment processing.
- Prepare as hoc reports such as store transfers, specific customer or customer grouping trends, partial/delete trends and new generic or other drug utilization for the Pharmacy areas.
Experience / Requirements
- This person will be required to direct others in the Pharmacy Purchasing Department on the proper use of data and also suggest appropriate courses of action.
- Three ( 3) years' of experience in analytical or financial role
- Experience in a Managed Care or Claims environment preferred but not required
- Experience with SQL, Access, Oracle or 1010 Big Data Platform preferred
- Bachelor's Degree in Arts/Sciences (BA/BS) required.