Healthcare Data Analytics Analyst (Healthcare, Pharmacy, Data Analysis, SQL, SAS, Tableau)
United States of America
Contract
2 weeks ago
$45 - $50 USD
No H1B
Key skills
Healthcare analyticsPharmacy analyticsPharmacy claims analysisFormulary performance analysisDrug utilization trendsMedication adherence metrics (PDC/MPR)Predictive modelingExplanatory modelingPharmacy outcomes researchUtilization managementDrug trend analysisSASSAS Enterprise MinerSQLRPythonTableauPharmacy pricing methodologies AWPPharmacy pricing methodologies WACPharmacy pricing methodologies MACPharmacy pricing methodologies rebatesPopulation health interventionsRisk adjustmentClinical groupersclassification systems GPIclassification systems NDCclassification systems therapeutic classclassification systems DRGclassification systems HCCPharmacy quality metrics HEDISPharmacy quality metrics STAR ratingsCommercialMedicare Advantage pharmacy optimizationU.S. healthcare system - payer settingPharmacy benefit management (PBM) operationsAnalytical skillsAnalyticsCommunicationDecision MakingCritical ThinkingProblem Solving
About this role
Strategic Staffing Solutions is offering a Healthcare Data Analytics Analyst opportunity for a leading Healthcare Insurance client. The role focuses on providing advanced analytics to enhance pharmacy benefit utilization, cost, quality, and clinical outcomes, while collaborating with various departments to drive strategic decision making.
Responsibilities:
- Independently provides advanced analytics to support understanding and improvement of pharmacy benefit utilization, cost, quality, and clinical outcomes
- Develops analytic attributes related to pharmacy utilization management, drug cost optimization, formulary performance, medication adherence, and provider/member pharmacy engagement
- Leads complex problem solving, solution development, and data‑driven strategic decision making
- Accountable for compliance with all applicable laws and regulations associated with pharmacy data and analytics responsibilities
- Independently designs and delivers analytics that improve how pharmacy services are valued, utilized, and provided
- Develops patient‑ and provider‑level analytics including pharmacy utilization and outcomes, medication adherence and persistence, formulary and rebate optimization, pharmacy cost management, and pharmacy‑driven quality measures
- Supports enterprise initiatives across Pharmacy Operations, Medical Management, Actuarial, and Clinical teams
- Serves as a subject matter expert in pharmacy analytics and translating complex business questions into actionable insights
Requirements:
- 4 years of healthcare analytics experience, with pharmacy or PBM analytics experience strongly preferred
- Experience analyzing pharmacy claims, formulary performance, drug mix, utilization trends, rebates, and adherence metrics (PDC/MPR)
- A Master's degree may substitute for two years of required experience; a Doctorate may substitute for an additional two years
- Strong critical thinking, analytical, and problem‑solving skills
- Experience building predictive and explanatory models related to pharmacy utilization, cost, and outcomes
- Knowledge of pharmacy outcomes research, utilization management, and drug trend analysis preferred
- Advanced knowledge of SAS (including Enterprise Miner) preferred
- Strong working knowledge of the U.S. healthcare system in a payer setting, with specific understanding of pharmacy benefits and PBM operations
- Proficiency with SQL, SAS, R, Python, Tableau, or similar analytic/visualization tools
- Pharmacy pricing and payment methodologies (AWP, WAC, MAC, rebates, trend drivers)
- Population health and pharmacy‑driven interventions
- Risk adjustment concepts and pharmacy's role in total cost of care
- Clinical groupers and classification systems including GPI, NDC, therapeutic class, DRG, HCC, and related models
- Pharmacy‑related quality metrics (HEDIS medication measures, STAR ratings)
- Excellent verbal and written communication skills
- Ability to translate complex pharmacy analytics into clear insights for executive, clinical, and technical audiences
- Bachelor's degree in healthcare administration, pharmacy, public health, statistics, economics, analytics, computer science, or related field required
- Four years of related experience may substitute for a Bachelor's degree
- Knowledge of commercial and Medicare Advantage pharmacy optimization is a plus
- Master's degree in a related field preferred