Pharmacy Program Performance Analyst

Hi, we’re Gravie. Our mission is to improve the way people purchase and access healthcare through innovative, consumer-centrichealth benefit solutions that people can actually use. Our industry-changing products and services are developed and delivered by adiverse group of unique people. We encourage you to be your authentic self - we like you that way.
We’re looking for a Pharmacy Program Performance Analyst to join our Pharmacy Operations team to help monitor . The PharmacyProgram Performance Analyst is responsible for leading reporting and reconciliation of pharmacy related claims, clinical programs,rebates, and data exchanges between Gravie and our vendor partners. This role will partner with internal analytics and operationsteams, as well as outside vendors, to ensure performance quality in the pharmacy space for Gravie’s members and plan sponsors.
You will:● Be responsible for PBM claims reconciliation, daily monitoring of incoming claims transactions, and reconciliation/approval ofPBM invoices.● Review Weekly claims reconciliation between various internal and external systems and databases.● Handle PBM rebate reporting and reconciliation, program and admin fee reconciliation, and Performance guaranteemonitoring.● Quarterly claims submission to vendors for medical claim rebates.● Claims to medical rebate reconciliation.● Open balance triage with clinical and claims operations teams for medical rebates.● Create reporting dashboards for analysis of medical rebate performance.● Modeling potential future medical rebate savings opportunities.● Develop and implement pharmacy performance dashboards including paid claims and rebates, trends, call center monitoring,utilization management, PrudentRx and overall specialty performance tracking.
You Bring● 3 + years of experience working with pharmacy and medical pharmacy claims, with an emphasis on reporting● Experience working with cross functional teams to understand business strategy and implement defined processes.● Data analyst experience, with a history of creating new dashboards and models for tracking and monitoring purposes.● Strong skills with systems including Excel, Tableau, Salesforce, and claims processing platforms for both PBM and medical.● Fact-based problem solver with the ability to evaluate alternative courses of action and make sound engagement decisions.● Able to deal with multiple priorities and deal with ambiguity.
Extra Credit:● Bachelor of Science Degree or equivalent experience in pharmacy and medical healthcare administration.● Previous PBM experience, specifically within operations, analytics, and/or pricing.● Previous start-up experience is a plus.● Prior knowledge of clinical programs, pharmacy claims processing, medical claims as they relate to pharmacy.
Competitive pay is standard. Our unique benefits program is the gravy, i.e., the special sauce that sets our compensation packageapart. In addition to standard benefits, Gravie’s package includes alternative medicine coverage, flexible PTO, up to 16 weeks paidparental leave, paid holidays, cell phone reimbursement, education reimbursement, and 1 week of paid paw-ternity leave just to name afew.