Pharmacy Program Optimization Analyst

Pharmacy Program Optimization Analyst will maximize the efficiency and effectiveness of partner’s federal drug pricing programs by analyzing pharmacy claims data and identifying opportunities for improvement. The role involves strong analytical skills, adaptability, and a willingness to learn complex domains. Prior healthcare experience is not required.

Requirements

• Analyze pharmacy claims data across multiple partners to identify trends, anomalies, and missed revenue opportunities.
• Evaluate billing configurations, payer carve-out logic, and submission pathways to ensure claims are routed correctly and in compliance with program requirements.
• Query and analyze data from EHRs, TPAs, and pharmacy operating systems to validate eligibility, utilization, and claim capture, identifying optimization opportunities across workflows.
• Troubleshoot live data, system, and integration issues that impact program eligibility, utilization, or optimization.
• Build and maintain reporting to track monthly savings, utilization, and performance trends, supporting financial optimization, forecasting, and leadership visibility.

Benefits

• Equal investment and support for our people and patients.
• A fun and ambitious start-up environment with a culture that takes on important things, takes risks, and learns quickly.
• Full-time employees are eligible to participate in our benefits package which includes Medical, Dental, Vision Insurance, Paid time off, Short- and Long-Term Disability, and more.