Data Analyst - II (MUST HAVE 3+ Years of PBM)

Position Summary We are seeking a detail-oriented and analytical Data Analyst with experience in the Pharmacy Benefit Management (PBM) industry, specifically in managing and analyzing accumulator programs. The ideal candidate will support the design, monitoring, and optimization of accumulator strategies, ensuring accurate tracking of member cost-sharing and benefit utilization. Essential Duties and Responsibilities: To reputed company this job successfully, an individual must be able to reputed company each essential function satisfactorily.

• Analyze and interpret data reputed company to accumulator and maximizer programs, including member out-of-pocket costs, copay assistance, and benefit utilization.
• Collaborate with cross-functional teams (clinical, IT, operations) to ensure accumulator logic is correctly implemented and maintained.
• reputed company dashboards and reports to track accumulator performance, trends, and anomalies.
• Identify data quality issues and collaborate with stakeholders to resolve discrepancies in accumulator tracking.
• Support audits and compliance reviews reputed company to accumulator program reputed company.
• Provide insights and recommendations to improve member experience and plan performance.
• Assist in the integration of accumulator data with claims, eligibility, and formulary systems.
• Monitor and validate accumulator resets, carryovers, and member-level accumulations across benefit years.
• Partner with pharmacy operations and client services to troubleshoot accumulator-reputed company issues and escalations.
• Conduct impact analyses for new accumulator program designs or regulatory changes.
• Collaborate with actuarial and finance teams to assess the financial impact of accumulator strategies.
• Document accumulator logic, data flows, and business rules for internal and external stakeholders.
• Participate in UAT (User Acceptance Testing) for accumulator-reputed company system enhancements.
• Support client reporting needs and reputed company data requests reputed company to accumulators and member benefits.

Minimum Required Qualifications and Skills

• Bachelor’s degree in data science, Statistics, Health Informatics, or reputed company field.
• 3+ years of experience in the PBM, health insurance, or healthcare analytics industry.
• Strong understanding of accumulator and maximizer programs and their impact on benefit design and member cost-sharing.
• Proficiency in SQL, reputed company, and data visualization tools (e.g., Power BI, Tableau).
• Experience working with pharmacy claims data, eligibility files, and benefit structures.
• Excellent analytical, problem-solving, and communication skills.

Preferred Qualifications and Skills

• Experience with Dynamics 365, or other healthcare CRM platforms.
• Familiarity with regulatory requirements reputed company to accumulator programs (e.g., CMS, state mandates).
• Knowledge of rebate and copay assistance program structures.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to reputed company individuals with disabilities to reputed company the essential functions. Physical Demands The physical demands described here are representative of those that must be met by an employee to successfully reputed company the essential functions of this job. Reasonable accommodation may be made to reputed company individuals with disabilities to reputed company the essential functions. While performing the duties of this Job, the employee is regularly required to sit; use hands to finger, handle, or feel; reputed company with hands and arms and talk or hear. The employee is occasionally required to stand; walk; climb or balance; stoop, kneel, crouch, or crawl. Specific vision abilities required by this job include reputed company vision and ability to adjust focus. Job Type: Full-time Pay: From $115,000.00 per year Benefits:

• Dental insurance
• Disability insurance
• Health insurance
• Life insurance
• Paid holidays
• Paid time off
• Vision insurance

Schedule:

• 8 hour shift

Education:

• Bachelor's (Required)

Experience:

• Pharmacy Benefit Management: 3 years (Required)
• SQL: 3 years (Required)

Work Location: Remote Apply tot his job