UPMC Health Plan has an exciting opportunity for a Pharmacy Data Strategist in the Pharmacy Services department. This is a full time position working Monday through Friday daylight hours and will be a remote position.
The Pharmacy Data Strategist applies expert experience to produce in-depth reporting and analytics for the pharmacy department. Clients include internal business line leaders and insurance division executive management, as well as external constituents and vendor opportunities. The Pharmacy Data Strategist must have the ability to manage data set infrastructure, and other technical processes for integrating healthcare pharmacy data elements from disparate sources throughout the UPMC enterprise. Manage comprehensive strategic analysis of data and information for various UPMC Health Plan products and programs. This integration results in a layer of information that guides pharmacy activities including strategic analysis, trend management, and clinical program evaluation.To successfully perform the role, the Pharmacy Data Strategist must be highly professional and understand the causes of financial & clinical trends and anomalies. The position requires the ability to articulate these opportunities to internal and external audiences, implement the solutions, and track and monitor progress.The Senior Pharmacy Data Strategist will take a leadership role in the pharmacy analytic department and provide enhancement, development, documentation, and communication of strategic opportunities, program development, and business trend modeling for the pharmacy department.
Responsibilities:
- Ability to perform and display sophisticated analyses and then be able to explain this analysis to a non-technical audience of both internal and external customers including senior management.
- Develop data extraction and integration processes to support analysis, data science, clinical operations, and decision support activities.
- Highly responsive to requests, the ability to prioritize and complete the requests as they come from multiple constituents.
- Knowledge and wherewithal to only release analysis that are completely vetted and consistent with previously approved financial statements.
- Subject matter expert with regards to financial metrics and the PBM reconciliation.
- The claims and the contractual metrics are evaluated monthly and adjusted to meet the needs of the business, the PBM and the marketplace dynamics.
- Specialty reporting and clinical program evaluations support the total cost of care model and without the level of expertise in the analysis the cost of specialty care would not be managed efficiently.
- Create and perform financial and clinical analyses, explain this analysis to a non-technical audience of both internal and external customers, including senior management, and present the request in a purposefully manner that translate to all audiences.
- Identify trends in expenses, pharmacy utilization, medical drug. Investigate variances and determine viable solutions to cost increases and quality issues.
- All processes developed are implemented and monitored effectively ensure the solutions are effective and ongoing.
- Oversee and provide guidance to peers and serve as reference points for questions on day-to-day basis.
- Will coordinate the orientation of new staff members and acts as an ongoing consultant to the data as a senior SME in pharmacy IDW data and medical drug spend.
- Maintain policies and procedures of the team / department.
- All processes are well documented and cross-trained within department.
- Perform validation and ensure quality standards for data sets created by fellow team members.
- Investigate data errors/variances and derive solutions with appropriate follow-up monitoring.
- Make recommendations for optimal data extraction, manipulation, and integration methodologies based upon research and analysis.
- Provide technical consultation and act as reference point to peers, other business areas, senior leadership and external customers.
- Meet deadlines and turnaround times set by supervisor. (These deadlines will, at times, require the employee to work until the project is completed, meaning extended daily work hours, extended work weeks, or both.)
- Maintain up-to-date information on status and effort related to each project.
- Adopt and promote best practices, tools, and methods set by team/department leadership.
- Develop and maintain working relationships with internal UPMC health Plan departments, and external contacts as appropriate.
- Minimum: Bachelor's degree in information systems, data management, healthcare management, business, or related field.
- Master's or other advanced degree is preferred.
Prior Work Experience:
- Minimum of five years of work experience in information technology, healthcare, business, or research is required.
- Experience in health insurance or healthcare industry is preferred, but those with relevant experience in other industries may be considered.
- Data and Technology experience and technical proficiency in SQL is required.
- Experience with other programming languages used in data science (such as R) is valuable.
- Extensive experience in other programming languages may be considered.
- Experience with extraction and manipulation of large, complex data sets is required.
- Experience managing/preparing data sets for use in analysis, modeling, or business operations is required.
- Experience with Microsoft Office products (particularly Excel) is required.
- Experience with data visualization tools (such as Tableau, QlikView, or PowerBI) is valuable.
Other Work Skills:
- Intermediate-level problem-solving skills are required.
- The ability to effectively communicate issues and results, verbally and in writing, is required.
- The ability to use effective time management skills, including prioritization of multiple tasks, is necessary for success.
- Attention to detail is critically important in this role.
- Ability to succeed in a fast-paced, ambiguous/fluid environment.
- A strong customer/stakeholder focus is expected at all times.
- The successful Analytics Data Integration Developer, Associate, is a team player that always displays professionalism.
- Ability to work extra hours if required.
Licensure, Certifications, and Clearances:
- Act 34
UPMC is an Equal Opportunity Employer/Disability/Veteran