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Pharmacy Benefits Analyst
Foundation Risk Partners, one of the fastest growing insurance brokerage and consulting firm in the US, is expanding its Pharmacy Benefits division with the addition of a Pharmacy Benefit Management (PBM) Analyst.
Job Summary:
We are seeing a motivated and detail-oriented PBM Analyst to join our dynamic analytics team. This team has developed automated comparison and annual reconciliation tools to support our clients and internal stakeholders. This is a fully remote position with a corporate office located in Florida.
Essential Functions:
- Produce savings analyses comparing PBM offers to determine the most cost-effective choice by utilizing claims data or pharmacy performance reports.
- Perform RFP analyses and report preparation while offering support to internal consultants.
- Perform plan design modeling for both existing and prospective clients.
- Perform requested ad hoc analysis based on client or broker requests.
- Utilize claims data to produce KPI, plan performance, and other ad hoc reports as requested.
- Perform invoice to claim data validations.
- Perform claims reviews which may include discount, dispensing fee, and rebate guarantees, benefit design, rebate contracts, performance guarantees, and claims repricing.
- Assist consultants with: data review for existing clients utilizing data and reports from various vendors, monitoring plan performance, identifying problem areas, as well as cost savings opportunities.
- Assist with the review of reports and presentations, and with presenting report of findings presentations.
- Monitor discount and rebate guarantees for our existing client base.
- Maintain monthly, quarterly, and annual reports.
- Communicate with the team and provide updates via email, video conference calls and/or phone calls.
Qualifications:
- Minimum of 5 years of experience in pharmacy benefit analytics, auditing, or a related role within the PBM or healthcare industry.
- Proficiency in Microsoft Excel (e.g., pivot tables, formulas, charts) and Microsoft Access (e.g., queries, data relationships).
- Experience working with large healthcare datasets, including claims data.
- Familiarity with pharmacy claims adjudication systems and PBM pricing models.
- Strong analytical and critical thinking skills with the ability to translate data into actionable insights.
- Ability to work independently in a remote, fast-paced environment with minimal supervision.
- Excellent verbal and written communication skills.
Preferred Qualifications:
- Working knowledge of rebate contracts, discount guarantees, and performance metrics in the pharmacy benefit space.
- Experience presenting analytical findings to internal and external stakeholders, including non-technical audiences.
- Knowledge of healthcare regulations, including HIPAA and transparency regulations.
Disclaimer:
While this job description is intended to be an accurate reflection of the job requirements, management reserves the right to modify, add, or remove duties from particular jobs and to assign other duties as necessary.
Equal Employment Opportunity (EEO):
FRP provides equal employment opportunity to qualified persons regardless of race, color, sex, religion, national origin, age, sexual orientation, gender identity, disability, veteran status, or any other classifications protected by law.
Benefits:
FRP offers a comprehensive range of health-related benefit options including medical, vision, and dental. We offer a 401(k) with company match, company paid life insurance, STD, LTD and a generous PTO policy starting at 18 days per year plus 10 paid holidays & 2 floating holidays!
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