Business Analyst II-Managed Care Pharmacy (Remote)
Posted 2025-03-15JOB SUMMARY/PURPOSE
? Performs advanced data analysis using complex tools and advanced techniques. Leads major data-intensive projects that span multiple departments including business process reengineering and technical efforts, and system implementation projects. Maintains an extensive knowledge of department compliance requirements, available data, and current processes to develop suggestions for process, tool or software, and/or reporting improvements. Provides data visualization that supports leadership in oversight, management, and strategic planning.
DEPARTMENT DESCRIPTION
? Samaritan Health Plans (SHP) operates a portfolio of health plan products under several different legal structures: InterCommunity Health Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services? self-funded employee health benefit plan. As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services? mission of Building Healthier Communities Together.
EXPERIENCE/EDUCATION/QUALIFICATIONS
? Bachelor's degree or equivalent experience in a related field required. Master's degree preferred.
? Two (2) years business analysis project coordination related experience required.
? Experience and/or training in computer and database applications required.
? Experience and/or training in statistics, computer science, data management or similar fields preferred.
Pharmacy Data Focus
? Strong knowledge of the principles of managed care, pharmacy benefit management, pharmaceutical reimbursement, and pharmaceutical utilization
? Proficiency with computer software programs, e.g. MS Outlook, Word, PowerPoint and Visio
? Advanced Proficiency with MS Excel for data tracking, manipulation, formulas, and creating pivot tables, graphs and charts, and other advanced functions required
? Competency using business intelligence platforms (e.g., Tableau, Power BI) for data blending, joining, and other advanced functions to implement complex business logic
? Ability to critically evaluate information gathered from multiple sources
? Ability to analyze large data sets using tools such as SQL/SAS/SPSS
? Ability to design and review pharmacy claims analysis/reports according to specific project requirements; and ability to prepare narrative reports
? Ability to read, analyze, and interpret technical procedures, or governmental regulations
KNOWLEDGE/SKILLS/ABILITIES
? Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Ability to work with all levels within the organization, facilitate communication, and effectively document related activities.
? Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions.
PHYSICAL DEMANDS
? Rarely
(1 - 10% of the time)
Occasionally
(11 - 33% of the time)
Frequently
(34 - 66% of the time)
Continually
(67 ? 100% of the time)
CLIMB - STAIRS
LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs
LIFT (Knee to chest: 24"-54") 0 ? 20 Lbs
LIFT (Waist to Eye: up to 54") 0 - 20 Lbs
CARRY 1-handed, 0 - 20 pounds
BEND FORWARD at waist
KNEEL (on knees)
STAND
WALK ? LEVEL SURFACE
ROTATE TRUNK Standing
REACH - Upward
PUSH (0 - 20 pounds force)
PULL (0 - 20 pounds force)
SIT
CARRY 2-handed, 0 - 20 pounds
ROTATE TRUNK Sitting
REACH - Forward
MANUAL DEXTERITY Hands/wrists
FINGER DEXTERITY
PINCH Fingers
GRASP Hand/Fist
PI261223104
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