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Director, Pharmacy Pricing Analytics

RxBenefits, Inc.
Sioux Falls, South Dakota, US
Full-time

Making sure you fit the guidelines as an applicant for this role is essential, please read the below carefully.

In this multi-disciplinary, cross functional role, the Director, Pharmacy Pricing Analytics will report to the Senior Director, Strategic Pricing & Analytics.

The Director, Pharmacy Pricing Analytics is a key contributor to the financial reporting, and client retention process and execution.

This role is responsible for maintaining updates and accuracy of financial performance quarterly reports as well as renewal pricing reports.

Additionally, this role’s functions include client retention efforts with claim file requests, current account RFPs, and competing PBM comparisons.

The Director also assists with resolving client issues involving rebate payment discrepancies and 340B related concerns.

This role will support the Senior Director, Strategic Pricing & Analytics to continue to develop and support the process of evolving Pricing and Analytics functions.

The successful Senior Financial Reporting Manager will be able to manage multiple projects at once, serve as a team player, and champion our mission and culture.

Essential Job Responsibilities Include :

  • Review for accuracy and finalize all current account RFPs for submission
  • Provide strategic insight and support the AM and Deal Governance teams for At-Risk accounts
  • Manage and support the current account claim and data requests
  • Respond to competing PBM offers to show RxBenefits pricing value and defend at-risk accounts
  • Prepare quarterly reports associated with financial performance
  • Lead the production and delivery of all current account annual renewal reporting (Pricing refresh & comparison)
  • Support the PBM Pricing Analyst with validating new pricing products in Salesforce
  • Perform key audits for new pricing enrollments and monthly contract guarantee performance
  • Validate and test updates in SAS associated with pricing and exclusions to maintain reporting accuracy
  • Manage the maintenance of PBM reference data including Specialty, Formulary, Exclusion, and Network lists
  • Research and analyze discrepancies between projected rebates and payments received
  • Act as point of contact for the PBM partners to resolve pricing discrepancies
  • Partner with the Strategic Hospital team and act as internal 340B SME
  • Model pricing improvements and assist with PBM negotiations for improved renewal pricing and terms
  • Provide BOB trends and savings for broker presentations
  • Identify gaps and opportunities in the current processes for enhanced visibility and efficiency
  • Directly manages and supports a team to review progress, ensure achievement of key outcomes, and provide professional development opportunities for team members
  • Act as a cross-functional representative throughout the organization to provide strategic insight and support organization goals and initiatives
  • Lead the development and application of advanced analytics techniques driving operational efficiencies, providing consultative support, enabling informed decision making, and producing KPIs for senior leadership
  • Analyze data to uncover potential issues / provide financial impacts
  • Provide custom analytics / modeling for ad-hoc projects

Required Skills / Experience :

  • 10 years of professional work experience in Pharmacy Benefit Management (PBM) or equivalent, is required
  • Bachelor’s degree is required
  • 2+ years of PBM pricing or RFP experience is strongly desired.
  • Expert interpersonal, communication, and collaborative management skills
  • Advanced knowledge of Microsoft Office
  • Strong team building, relationship management, and project management skills
  • Independent / self-starting nature
  • Process and procedure oriented
  • Highly competent problem solver
  • This position may work from our Birmingham, AL headquarters or remotely from home.

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1 day ago
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