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Milliman

Pharmacy Benefits Analytics Manager (CMH Health)

Milliman, Windsor, Connecticut, us, 06006

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Pharmacy Benefits Analytics Manager (CMH Health)

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Individua(s) must be legally authorized to work in the United States without the need for immigration support or sponsorship from Milliman now or in the future. Milliman’s CMH Health practice is seeking a

Pharmacy Benefits Analytics Manager

to work in a fast-growing area of the Health practice. This role will involve accurately diagnosing client problems, developing project proposals, refining project strategy, outlining a project plan, managing internal resources, and presenting the results to the client. The Pharmacy Benefits Analytics Manager may assist clients such as employers, health plans, PBMs, and pharmaceutical companies.

Who We Are Independent for 75 years, Milliman delivers market-leading services and solutions to clients worldwide. Today, we are helping companies take on some of the world’s most critical and complex issues, including retirement funding and healthcare financing, risk management and regulatory compliance, data analytics and business transformation.

Job Responsibilities

Provide qualitative and financial evaluations of PBM contracts, including pricing and fee schedules

Assist with developing models to conduct detailed analyses of pharmacy data, including pharmacy claims, eligibility data, etc.

Acquire, standardize, and merge various data sets to provide summarized reports

Contribute to drafting proposals, presentations, exhibits, RFPs, and reports

Manage client relationships, projects, assignments, presentations, and deliverables

Be able to work independently, but also actively lead teams utilizing pharmacy data expertise on various projects

Potential projects could include

Trend Related Modeling and Analysis

Analyzing pharmacy data to provide innovative pricing solutions

Medicare Part D, Medicaid, and Commercial Pharmacy Formulary and Pricing Analysis

Medicare Part D Fraud, Waste, and Abuse Monitoring

Evaluation of New Product Pipeline (e.g., evaluating impact of agents for NASH, oncology drugs, etc.)

Pharmaceutical Company Strategy Support (e.g., analytics to support formulary negotiations and modeling)

Minimum Requirements

Bachelor’s degree required

A minimum of four years of experience in the pharmacy industry (ex. PBM, health plan, retail pharmacy etc.)

Extensive knowledge of pharmacy claims reimbursement (ex. WAC, AWP, discounts, rebates, etc.)

Experience with handling large pharmacy claims datasets

Experience creating models and reports focused on opportunities for formulary management, prior authorizations, drug pricing, etc.

Strong business software capabilities, especially with Microsoft office tools (Excel) and data analysis technologies (SAS/SQL)

Competencies and Behaviors that Support Success in this Role

Analytical thinking and the ability to evaluate analyses for downstream impact

Creative problem solving and analytical skills.

Superior verbal and written communication skills

Client focused and results oriented

Ability to work independently and in a team environment

Self-motivated, creative, and resourceful

The Team Milliman is one of the leading experts in healthcare financing and delivery. We advise clients on a wide range of issues—from assessing the impact of healthcare reform on organizations or populations to streamlining operations while advancing the quality of patient care. Our consulting work is supported by a powerful toolkit of data analytics solutions and informed by the most trusted, comprehensive set of cost guidelines in the industry.

Through a team of professionals ranging from actuaries to clinicians, technology specialists to plan administrators, we offer unparalleled expertise in employee benefits, investment consulting, healthcare, life insurance and financial services, and property and casualty insurance.

Salary The overall salary range for this role is $117,500 - $222,985.

For Candidates Residing In

$135,125 - $222,985

All Other States

$117,500 - $193,900

A combination of factors will be considered, including, but not limited to, education, relevant work experience, qualifications, skills, certifications, etc.

Location It is preferred that candidates work on-site at our Brookfield, WI, Chicago, IL, or Hartford, CT office, however, remote candidates will be considered.

Benefits

Medical, Dental and Vision – Coverage for employees, dependents, and domestic partners.

Employee Assistance Program (EAP) – Confidential support for personal and work-related challenges.

401(k) Plan – Includes a company matching program and profit-sharing contributions.

Discretionary Bonus Program – Recognizing employee contributions.

Flexible Spending Accounts (FSA) – Pre-tax savings for dependent care, transportation, and eligible medical expenses.

Paid Time Off (PTO) – Begins accruing on the first day of work. Full-time employees accrue 15 days per year, and employees working less than full-time accrue PTO on a prorated basis.

Holidays – A minimum of 10 observed holidays per year.

Family Building Benefits – Includes adoption and fertility assistance.

Paid Parental Leave – Up to 12 weeks of paid leave for employees who meet eligibility criteria.

Life Insurance & AD&DD – 100% of premiums covered by Milliman.

Short-Term and Long-Term Disability – Fully paid by Milliman.

Equal Opportunity All qualified applicants will receive consideration for employment, without regard to race, color, religion, sex, sexual orientation, national origin, disability, or status as a protected veteran.

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