Other - CW SR Healthcare Informatics Analyst

Senior Healthcare Informatics Analyst – Pharmacy Analytics

The Senior Healthcare Informatics Analyst – Pharmacy Analytics independently designs and delivers analytics that improve how pharmacy services are valued, utilized, and provided. This role develops patient- and provider-level analytics including pharmacy utilization and outcomes, medication adherence and persistence, formulary and rebate optimization, pharmacy cost management, and pharmacy-driven quality measures. The analyst supports enterprise initiatives across Pharmacy Operations, Medical Management, Actuarial, and Clinical teams, serving as a subject matter expert in pharmacy analytics and translating complex business questions into actionable insights.
Necessary Contacts: To effectively fulfill this position, the incumbent will collaborate with Pharmacy Operations, PBM partners, Clinical Solutions, Actuarial, Provider Reimbursement, Payment Innovation, IT, Marketing, external vendors, the Client Cross Association, PBMs, and other Client plan partners.
Qualifications

Education: Bachelor's degree in healthcare administration, pharmacy, public health, statistics, economics, analytics, computer science, or related field required. Master's degree in a related field preferred.
Work Experience: Four years of related experience may substitute for a Bachelor's degree.
Work Experience: 4 years of healthcare analytics experience, with pharmacy or PBM analytics experience strongly preferred. Experience analyzing pharmacy claims, formulary performance, drug mix, utilization trends, rebates, and adherence metrics (PDC/MPR).
Skills and Abilities: Strong critical thinking, analytical, and problem-solving skills. Experience building predictive and explanatory models related to pharmacy utilization, cost, and outcomes. Knowledge of pharmacy outcomes research, utilization management, and drug trend analysis preferred. Advanced knowledge of SAS (including Enterprise Miner) preferred. Strong working knowledge of the U.S. healthcare system in a payer setting, with specific understanding of pharmacy benefits and PBM operations. Technical Skills: Proficiency with SQL, SAS, R, Python, Tableau, or similar analytic/visualization tools. Domain Expertise (Desired): Pharmacy pricing and payment methodologies (AWP, WAC, MAC, rebates, trend drivers). Population health and pharmacy-driven interventions. Risk adjustment concepts and pharmacy's role in total cost of care. Clinical groupers and classification systems including GPI, NDC, therapeutic class, DRG, HCC, and related models. Pharmacy-related quality metrics (HEDIS medication measures, STAR ratings). Knowledge of commercial and Medicare Advantage pharmacy optimization is a plus. Excellent verbal and written communication skills. Ability to translate complex pharmacy analytics into clear insights for executive, clinical, and technical audiences.
Licenses and Certifications: None required.
Accountabilities and Essential Functions

Leads the selection and application of pharmacy-focused analytic, evaluation, and BI methodologies to support business decisions and strategic planning. Leverages pharmacy claims data, PBM feeds, EDW data sources, and non-EDW datasets to deliver actionable insights. Independently partners with business teams to define pharmacy analytics needs and develop solutions such as predictive models, dashboards, utilization analyses, and performance metrics. Serves as a pharmacy analytics advisor on enterprise and cross-functional initiatives. Translates pharmacy business rules and policies into analytical models and reporting solutions, acting as a liaison between Pharmacy, Analytics, IT, and EIM teams. Performs peer data quality reviews to ensure accuracy, completeness, and consistency of pharmacy analytics output. Conducts advanced descriptive and statistical analyses related to drug utilization, adherence, cost drivers, and clinical outcomes. Additional Accountabilities and Essential Functions: The physical demands described here are representative of those that must be met to successfully perform job functions. Reasonable accommodations may be made. Performs other job-related duties as assigned within scope of responsibility. Work is performed in a standard office environment with normal noise levels. Work is primarily sedentary (standing or sitting). Ability to comprehend, document, calculate, visualize, and analyze complex data is required.
EEO: "Mindlance is an Equal Opportunity Employer and does not discriminate in employment on the basis of – Minority/Gender/Disability/Religion/LGBTQI/Age/Veterans."