Senior Reporting Analyst, Government Programs

What you’ll do:

In a few words…

Abarca is igniting a revolution in healthcare.  We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning…

From managing day-to-day pharmacy network operations, developing standard reporting, to crafting pricing and underwriting strategies, our Drug Value Strategy team is critical. The Senior Data Analyst is part of the Data Analytics team who drives the standardization and creation of Data Metrics reports using raw data to supply updates for audits, predictive models, and identify potential operational and clinical opportunities for both internal and external use.

As our Senior Reporting Analyst for Government Programs, you will be responsible for supporting our compliance program effectiveness through data analysis to identify risks and trends using data visualization and dashboards.  This may include generating ad hoc reports and regular datasets or report information for end-users using system tools and database or data warehouse queries and scripts. You will become a subject matter expert, proactively identifying the applicable regulation changes for Abarca, generating, and disseminating the data needed for analysis, as well as supporting the Regulatory Compliance Team and department leadership in making key policy decisions aimed at proactively mitigating risk and potential audit concerns.  

The fundamentals for the job…

• Understand data sources and the data to complete the reports and analyze the data with management.
• Transform raw data, using SQL and other querying languages, into automated reporting.
• Execute departmental reports at the required frequency with implemented quality check workflows.
• Analyze and review data on a regular basis to ensure compliance and consistency.
• Communicate data outliers to business owners (internal and external), leadership and Government Programs management.
• Complete ad hoc reporting/queries as needed as part of external audits.
• Develop working understanding of organizational structure to enhance our regulatory compliance program.
• Work with business areas to discuss identified changes in regulation, define required actions, and ensure requirements are implemented as appropriate.
• Perform data analysis and validation to ensure required accuracy and specifications.
• Participate in the Regulatory Change Management (RCM) Committee meetings, presenting regulatory updates and engaging participation of subject matter experts (SME’s).
• Perform research and review guidance to provide timely responses to regulatory questions from clients and business areas.
• Lead conversations with clients around regulatory requirements and any impact to the organization, including any potential audit concerns.
• Support HIPAA investigations, specifically review and keep track of applicable federal and state requirements, including State Medicaid requirements and Client Business Associate Agreements.

What we expect of you:

The bold requirements…

• Bachelor’s degree in business, healthcare, or related field (In lieu of a degree, equivalent relevant work experience may be considered.) 
• 5+ years’ experience in the healthcare industry
• Strong SQL query skills
• Strong understanding of industry processes, PBM Operations and Medicaid regulations
• Excellent oral and written communication skills.
• Experience with/ability to learn wide range of reporting tools (e.g., Reporting Services, Tableau)

Nice to haves…

• 2+ years’ experience with Medicaid or Medicare regulations (preferred)
• Certified in Healthcare Compliance (CHC), and/or Certified Fraud Examiner (CFE), and/or Certified Internal Auditor (CIA) (Preferred)
• Experience with Snowflake

Physical requirements…

• Must be able to access and navigate each department at the organization’s facilities.
• Sedentary work that primarily involves sitting/standing.

 

At Abarca we value and celebrate diversity. Diversity, equity, inclusion, and belonging are guiding principles of Abarca and ensure Abarca’s workforce reflects the communities it serves.  We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws. 

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