Executive Advisor - PBM Analytics

Executive Advisor - PBM Analytics

The Healthcare Innovation company is recruiting an experienced, enthusiastic, and innovative leader to join the Analytics organization focusing on prescription benefit management and specialty pharmacy area of the enterprise. In this important role supporting one of the core functions of our business, you will work closely with multiple business partners to deliver a range of analytic solutions to help enable data-driven decision-making to influence patient, caregiver, and prescriber experience and outcomes


You will focus on analytics understanding the impact of PBM offerings on enterprise KPIs and population health, and you will help identify opportunities for analytics to drive program innovation and improvement. You will develop analytic solutions that include assessment and stratification of patient populations, their needs, and opportunities to improve the convenience and cost-efficiency of PBM clinical and member-centric services.

The essential roles and responsibilities of the role are to:

• Partner with product innovation, as well as with clinical, operations, digital, and sales and marketing partners to identify existing and evolving business needs which can be effectively solved with a variety of analytic approaches.
• Engage with executive leadership to identify areas where analytics can drive business value, frame business problems into analytic questions, and translate analytics into business value.
• Develop and execute a prioritized analytic strategy to address the business needs and partner with analytic and technical/IT leaders as needed to deliver on the strategy.
• Partner with advanced analytics leaders to envision, define and deliver advanced analytic solutions to drive enhanced utilization management outcomes, such as case volume forecasting, automated outlier detection, predictive modeling based on artificial intelligence and machine learning techniques, population segmentation, and risk stratification.
• Deliver analytic solution methodologies and capabilities to enable automated insight generation and reporting, such as identification and closure of data gaps, metrics and measurement methodology development, design and prototyping of self-service reporting and data visualization solutions, and Adhoc analytic studies.
• Leverage core pharmacy and medical claims data as well as identify and utilize other data sources (EMR, lab results, clinical data and notes, consumer purchasing data, digital engagement data, etc.) to provide actionable and relevant and timely analytic insight.
• Collaborate with and mentor junior Master’s and Ph.D. level analytics professionals, playing a leadership role in analytic initiatives.

Required Qualifications
• 10 or more years of progressive experience in the analytics field.
• Excellent ability to establish and maintain collaborative relationships with analytic and non-analytic business partners, including executive leadership, in order to elicit business needs and formulate, propose and refine analytic solutions in order to meet the business needs and to drive efficiency and effectiveness improvements and business value.
• Experience leading project teams in a matrix environment.
• Solid understanding and hands-on experience with a variety of analytic processes and techniques, including health economics outcomes research, population health, measurement methodologies development, hypothesis testing, statistical significance testing, modeling, and machine learning.
• Solid understanding and hands-on experience working with large data sources, particularly administrative claims, digital engagement, and clinical program data, focusing on efficient data extraction from large databases, data manipulation, and setting up optimized summary data layers.
• Excellent written and oral communication and data presentation skills, with the ability to tailor the communication style to the right audience, from the analytic professionals to the senior business leaders.
• Excellent project management skills with the ability to lead and engage in multiple projects and initiatives and appropriately prioritize one's own time as well as that of contributing resources.
• Understanding of the healthcare administration landscape and familiarity with the PBM industry and business model, including patient and payer concerns
• Extensive hands-on experience with, SQL, Python, R, Tableau, and other data, statistical and data visualization tools and techniques, and ability to understand and adapt emerging analytic tools and solutions into the analytic standard operating procedures.

Preferred Qualifications
• Management consulting experience a plus.
• Project management experience a plus.
• Working knowledge of pharmacy benefits utilization management programs and experience in using analytics to drive behavior change

Bachelor’s degree in a related discipline, such as epidemiology, public health, statistics, biostatistics, health economics, pharmacy, or related field. Master’s or Ph.D. in a related field or MBA with training in statistics and health services utilization analytics strongly preferred.

Business Overview
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