Senior Government Programs Operations Analyst

Location: Remote (For Non-Local) or Hybrid (Local to NYC area or Denver, CO)

Position Summary:

The Sr Government Programs Operations Analyst under the direction of the team leaders will develop solutions to analyze, interpret, and report on a wide variety of data. This individual will analyze complex datasets to help garner critical insights that will be leveraged to make key business decisions. Additional responsibilities include – delivering recurring and ad-hoc reports, facilitating requirement gathering sessions, developing BI dashboards, establishing, and adhering to analytical best practices, and developing a repository of standard code templates to facilitate automation of deliverables. Will also collaborate with internal and external cross-functional teams (compliance, product, sales, marketing, underwriting, implementation, client services, and clinical operations) to design, refine, automate, and maintain operational capabilities.

Position Responsibilities:

• Supports Capital-Rx in developing reports that present key performance metrics as defined by client and regulatory guidelines – Including but not limited to encounter and PDE submission metrics

• Extracts and compiles various sources of data to produce insightful information

• Prepares any reporting mandated by government and client request

• Works with internal and external clients to research, develop, and document new standards to enhance reporting capabilities

• Implements and uses analytical software to support the department in achieving goals as defined by executive leadership

• Presents and communicates complex analytical findings in a clear and concise manner

• Participates in user acceptance, and quality assurance testing of new application features and team deliverables

• Supports root-cause-analysis and reporting of encounter data issues/errors by partnering with key stakeholders – Will also provide operationally support

• Monitors for changes in reporting requirements and updates documentation accordingly - Identifies new opportunities for process developments and improvements

• Proactively reviews business processes and data to develop subject matter expertise of processes supported by our team

• Analyzes business workflow and system needs for conversions and migrations to ensure that encounter, recovery, and cost savings regulations are met

• Prepares high-level user documentation and training materials as needed

• Collaborates with compliance to interpret and translate government reporting requirements into actionable recommendations/output

• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.

Required Qualifications:

• 3+ years of healthcare data experience

• 3+ years of proven experience in government programs

• 3+ years of experience working with SQL, R, or Python

• 2+ years of experience working with pharmacy data

• 2+ years of experience working with business intelligence tools

• Experience with Medicare(Part D), Medicaid, and/or Marketplace Pharmacy Data/Processes

• Experience performing analyses on large sets of data

• Knowledge of data management, statistics, modeling concepts

• Experience working with cross-functional teams

• Experience with Power BI or other data visualization tools

• Ability to balance multiple complex projects simultaneously

• Extremely flexible, highly organized, and able to shift priorities easily

• Attention to detail & commitment to delivering high-quality work product

• Experience with Medicare, Medicaid, and Government Exchange programs preferred

This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.

About Capital Rx 

Capital Rx is a health technology company providing claim administration and technology solutions for carriers, health plans, TPAs, employer groups, and government entities. As a public benefit corporation, Capital Rx is executing its mission to materially reduce healthcare costs as a full-service PBM and through the deployment of Judi®, the company’s cloud-native enterprise health platform. Judi connects every aspect of the healthcare ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of benefits and rebuilding trust in healthcare.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. 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.