Read, understand, and assess medical and pharmacy policies of US Health Insurance companies
Conduct detailed reviews of medical and pharmacy policies across Commercial, Medicare, and Medicaid plans
Assess policies based on payer coverage criteria, formulary status, prior authorization, step therapy, and other utilization management restrictions
Utilize analytics tools and methodologies to generate insights and provide recommendations for business improvements
Act as a thought partner, collaborating with internal teams to strategize and optimize business processes & rules
Communicate findings, implications, and recommendations to internal teams and external partners
Develop and maintain documentation related to policy assessments and compliance activities
Contribute to internal initiatives, including adhoc projects and employee engagement programs

Bachelor's degree in Life Sciences (Pharmacology, Dentistry, or a related field)
2 to 5 years of experience in Pharma/Healthcare (pharmacovigilance, insurance, health IT)
Certification in SQL, Power BI, or similar technical skills preferred
Prior experience in the corporate healthcare industry required
Solid knowledge of US healthcare regulations highly desirable
Familiarity with secondary data sources such as FDA databases, Redbook, and clinical labels preferred
Strong analytical mindset with keen attention to detail
Excellent interpersonal and communication skills
Proficient in Microsoft 365 and Google Suite Workspace
Technical expertise in Excel required; working knowledge of SQL and Python or similar programming language good to have.
Ability to work independently as well as collaboratively in a dynamic environment

Healthcare Data Analyst

Key skills