Pharmacy Data Claims Analyst & Insights at Elevance Health

Posted in Other about 2 hours ago.

Location: Miami, Florida





Job Description:

Pharmacy Data Claims Analyst & Insights (Business Analyst II)



Location: This position will work a hybrid model (1-2 days/week in office). The ideal candidate will live within 50 miles of our Miami, FL or Tampa, FL PulsePoint locations.


A proud member of the Elevance Health family of companies, CarelonRx (formerly IngenioRx) leverages the power of new technologies and a strong, clinical-first lens, to deliver member-centered, lasting pharmacy care.


The Pharmacy Data Claims Analyst & Insights (Business Analyst II) is responsible for translating basic business needs into data insights.



How you will make an impact:



  • Analyzes business needs to determine insights identifying cost of care and quality opportunities using pharmacy claims.

  • Determines specific data needs to address specific business needs.

  • Works with programming staff to incorporate data pull and insights into system design and testing.

  • Acts as liaison with users of the data to address questions/issues.




Minimum Requirements:



Requires a BA/BS and minimum of 3 years related business analysis experience, or any combination of education and experience, which would provide an equivalent background. Knowledge of systems capabilities and business operations is strongly preferred.



Preferred Skills, Capabilities, and Experiences:



  • Experience working in a health plan and/or pharmacy benefit manager (PBM) strongly preferred.

  • Strong proficiency in SQL, with demonstrated expertise in database management, creation, and optimization for efficient data storage and retrieval preferred.

  • Experience pulling pharmacy claims from EDW preferred.

  • Proficient in Microsoft Excel and VBA, with a solid understanding of advanced formulas, data manipulation techniques, and automation through custom macros preferred.

  • Skilled in using Report Builder, with the ability to design, develop, and customize data-driven reports to effectively communicate insights and drive informed decision-making preferred.

  • Proficient in Power BI and Tableau, adept at creating visually impactful and interactive dashboards for data analysis, visualization, and business intelligence purposes preferred.



For URAC accredited areas, the following professional competencies apply: Associates in this role are expected to have strong oral, written and interpersonal communication skills, problem-solving skills, facilitation skills, and analytical skills.


Please be advised that Elevance Health only accepts resumes for compensation from agencies that have a signed agreement with Elevance Health. Any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.

Who We Are

Elevance Health is a health company dedicated to improving lives and communities - and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve.

How We Work

At Elevance Health, we are creating a culture that is designed to advance our strategy but will also lead to personal and professional growth for our associates. Our values and behaviors are the root of our culture. They are how we achieve our strategy, power our business outcomes and drive our shared success - for our consumers, our associates, our communities and our business.

We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.

Elevance Health operates in a Hybrid Workforce Strategy. Unless specified as primarily virtual by the hiring manager, associates are required to work at an Elevance Health location at least once per week, and potentially several times per week. Specific requirements and expectations for time onsite will be discussed as part of the hiring process. Candidates must reside within 50 miles or 1-hour commute each way of a relevant Elevance Health location.

The health of our associates and communities is a top priority for Elevance Health. We require all new candidates in certain patient/member-facing roles to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide an acceptable explanation. Elevance Health will also follow all relevant federal, state and local laws.

Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact elevancehealthjobssupport@elevancehealth.com for assistance.
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