About the position
The Program Analyst is a vital role within Prime Therapeutics, responsible for providing project coordination and administrative support across various functional areas including Clinical Program Management, Utilization Management (UM), Formulary, GuidedHealth, Pharmaceutical Trade Relations, Pharmacy Audit, Clinical Operations, and Specialty Pharmacy. This position plays a crucial part in ensuring that the organization meets its goals of delivering quality healthcare services and improving patient outcomes. In this role, the Program Analyst will partner with internal business partners to develop, generate, analyze, quality check, and coordinate the delivery of both client and internal program reporting. This may include reports on UM Savings, Compliance, Utilization data, Retrospective Drug Utilization Review (DUR), Concurrent DUR, member eligibility information, and pharmacy or pharmaceutical performance analytics. The analyst will also support the Request for Proposal (RFP) and implementation processes by gathering necessary information and requirements, while effectively communicating status updates to key stakeholders. Additionally, the Program Analyst will work collaboratively with various internal departments to create and maintain communications and templates for clients, members, and physicians. This includes managing member disruption mailings and utilization requests, as well as participating in fulfillment activities when applicable. The role also involves developing and maintaining business process flows and desktop procedures for designated functional areas, and may include supporting clinical rules maintenance and client invoicing for programs. Other duties may be assigned as needed, making this a dynamic and engaging position within the organization.
Responsibilities
- Partner with internal business partners to develop, generate, analyze, quality check, and coordinate the delivery of client and internal program reporting.
- Support the RFP and implementation process by gathering information and requirements and communicating status updates to key business partners.
- Work with various internal departments to create and maintain client, member, and/or physician communications and templates, member disruption mailings, and utilization requests.
- Develop and maintain business process flows and desk top procedures for designated functional area.
- May support clinical rules maintenance (GPI lists, other lists) and/or client invoicing for programs.
- Other duties as assigned.
Requirements
- Bachelor's degree in business, finance, biology or other related field, or the equivalent combination of education and/or related work experience; HS diploma or GED is required.
- 2 years of work experience in healthcare, Pharmacy Benefit Management, business process administration, project management or other related experience developing and improving internal processes.
- Must be eligible to work in the United States without need for work visa or residency sponsorship.
- Demonstrated ability to complete projects independently and within established timeframes.
- Detail oriented and ability to work with a high degree of accuracy.
- Excellent organizational and communication skills.
- Proficiency in Adobe and Microsoft Office.
Nice-to-haves
- National Pharmacy Technician Certification through PTCB or ExCPT (CPhT).
- 3 years of PBM, Managed Care or Pharmaceutical/Trade experience.
- Project Management skills.
- Knowledge or experience with formulary or utilization management.
- Proficient in MS Access.
- Familiarity with Google Cloud Platform (GCP).
- Advanced Excel skills.
Benefits
- Health insurance
- Dental insurance
- Vision insurance
- 401k
- 401k matching
- Paid holidays
- Paid time off
- Flexible scheduling
- Professional development
- Tuition reimbursement
- Employee discount programs
