The Analyst, Pharmacy Program for Commonwealth Care Alliance's Pharmacy Department supports the Director of Pharmacy and pharmacy team by undertaking, owning, and being accountable for a variety of business, financial, quality, and organizational projects as related to pharmacy.
The analyst will report directly to the Manager of Clinical Pharmacy Programs and will be responsible for development of materials to support NCQA accreditation, clinical/operational activities, program performance reporting, scheduling, and organizing meetings, and providing administrative and project management support to the department's leaders.
Supervision Exercised: None
What You'll Be Doing
Program Coordination/ Management: Coordinate key aspects of projects and programs relating to the pharmacy department as assigned:
- Guide the design and implementation of key performance indicators and reporting to support pharmacy business plans and initiatives
- Contribute to the development of new tools and approaches to pharmacy program development
- Develop written deliverables relating to policy initiatives
- Support regulatory audits and pharmacy operational processes as necessary.
- Design and manage program evaluation by preparing and presenting summaries of analyses, project status reports and presentations to management team and key stakeholders.
- Own and manage pharmacy related programs as directed by Director of Pharmacy (ex: MTM, Specialty, Adherence Programs)
- Recommend and facilitate implementation of new pharmacy initiatives with PBM or vendor at Pharmacy Director direction
- Monitor data quality metrics and ensure business data and reporting needs are met (e.g., service level agreements, performance guarantees)
- Support pharmacy marketing opportunities (new materials, IVR, newsletters, website)
- Facilitate project coordination support related to reporting data including developing agendas, taking minutes, documenting action steps, communication, and follow-up with members of project group(s).
- Monitor project closeout activities, including transition plans and lessons learned.
- Lead the pharmacy team in NCQA readiness requirements. This includes but is not limited to the following:
- Work with internal and external stakeholders to identify and close NCQA accreditation gaps within identified timeframes
- Responsible to maintaining all NCQA standards relative to CCA's pharmacy team
- Lead the completion of scheduled gap analyses, annual updates, and performance monitoring to ensure ongoing compliance with NCQA standards
- Responsible for NCQA ancillary project plan which includes goals, timelines, task owners, challenges.
- Program documentation and readiness requirements including completion of annual updates.
Strategic Analysis: Analyze and evaluate industry dynamics to evaluate the current strategic position of Commonwealth Care Alliance in respect to pharmacy programs.
- Identify strategic opportunities and recommend modifications or proposed strategies and tactics using financial, economic, statistical, demographic, and clinical
- Collaborate with external contacts as required to support corporate or departmental strategic initiatives related to pharmacy
- Prepare and present recommendations to the applicable CCA committee or team based on trend
- Develop and prepare recommended refinements to strategy/objectives on an as needed basis, but minimally prior to the annual budget
Data Analytics: Develop and monitor data quality metrics and ensure business data and reporting needs are met
- Dashboard financial, clinical, operational, and quality (STAR and Withhold Measures) goals and metrics related to the pharmacy program
- Financial modelling for new to market drugs that could cause significant increase to PMPM
- Demonstrate the results of pharmacy initiatives per business plan and associated data outcomes
- Query pharmacy data in order to provide analysis and mapping of specific requests at the direction of the Director of Pharmacy
What We're Looking For
Education Desired:
- Bachelor's Degree
Experience Required:
- Requires 2 years of experience in business, pharmacy, or managed care environment, of which 2 years of demonstrated experience occurred within health care consulting, business/strategic planning, and/or project management settings.
- Some experience with influencing a diverse group of stakeholders.
Experience Desired:
- Experience with Medicare, Medicaid, populations preferred
Knowledge, Skills Abilities Required:
- Must be proficient at leveraging data and content to develop stakeholder presentations for targeted stakeholders
- Requires ability to assess all work and prioritize as necessary.
- Must be highly organized and able to juggle multiple priorities effectively.
- Must be able to work both autonomously and as a team player.
- Must have strong planning, problem solving, and analytic skills
- Must have strong Microsoft Office skills, especially within excel and project
- Must have the ability to operate in diverse computer systems and the tenacity to learn new ones as needed
- Must have critical thinking skills to understand complex implementations and gain depth in understanding subject matter.
- Interacts independently with various levels of CCA management, staff, providers, administrative personnel, and vendors.
Knowledge, Skills Abilities Desired:
- Some experience in SQL preferred
Language(s) Required:
- English