Clinical Operations Analyst

PBIRx is looking for a Clinical Operations Analyst who has one to three years’ experience in a health care business environment working with business processes and related data files that support key aspects of business service operations.

This person would be responsible for maintaining key components of a suite of clinical products & related services that are utilized by internal stakeholders and/or by vendors that administer these programs. Additionally, the position would help support the Clinical Specialist team with certain aspects of client reporting, clinical newsletter/article development and other tasks as needed. We are looking for a strong team player who is a self-starter with an analytical mind and skill set who embraces a team culture, has excellent organizational, time management and follow up skills. If you are looking for a challenging position with an employer willing to invest in your future career development in a changing but growing professional field, we welcome you to apply.

We hire intelligent, articulate, highly talented, ethical, detail oriented people who work well in a team environment with excellent verbal and written communication skills along with a professional image. Our staff have high standards, and we hold ourselves accountable to our clients and to one another. We are committed to ongoing learning every day, taking initiative on various and diverse projects to deliver optimal services to our clients.

Our staff includes IT personnel, actuaries, financial analysts, clinical pharmacists, attorneys, HIPAA Compliance Officers and experts in the pharmacy benefit management industry.

Our Company:

Established in 1993, PBIRx is a growing consulting and auditing company focusing on employee benefit services and programs that result in pharmacy benefit savings. Our headquarters is in Milford, Ct with a second location in St. Louis, MO.

PBIRx partners with prestigious clients, brokers, and consultants as their pharmacy benefit specialist, helping clients to evaluate, modify, design and execute solutions for their pharmacy benefit plan. Our team has a passion for providing targeted solutions to manage pharmacy costs for our diverse client base including hospitals, unions, municipalities, third party administrators and corporate clients.

Our Culture:

Our accessible leadership team cultivates an open door environment. We love ideas and people who can identify novel solutions for better efficiencies, and we value people who take initiative without having to be directed on a continuum. PBIRx thrives in a dynamic, fast paced environment and as such, working as a team is imperative.

Our Passion:

Our passion is to constantly reinvent ourselves in the ever changing world of health care and to bring value to our clients by constantly learning new information and developing new services for our clients along with mentoring our staff, which allows new career opportunities for everyone as PBIRx expands. 

Job Position:

The position is responsible for ensuring PBIRx’s clinical products and analytics reports are supported with ongoing maintenance of key data files that serve as the foundation of particular aspects of our reporting suite and clinical offerings. That work will entail coordinated certain data files from our PBM client vendors, PBIRx contracted vendors and our internal drug database. Additionally, the position will work to identify/mitigate errors in our data feeds by analyzing such data files to provide resolution recommendations and then work to coordinate such resolution with the internal and external stakeholders. The position will also involve working on team projects for new products, report development and process improvement exercises, which will include maintaining internal policy & procedures and standard operating procedure documents. Additionally, this role will involve supporting efforts for the development of relevant clinical content for the company website or news article/magazine publication. 

Job Responsibilities:

• Manage the ongoing updates to the PBIRx utilization management & formulary exclusion programs with Clinical and Analysis teams.
• Manage the updates to PBIRx specialty drug list, which includes obtaining updated specialty files for the various client PBMs vendors, evaluating such files and coordinating updates to PBIRx’s system lists with our Analysis department.
• Maintain the International Rx program drug list updates from our contracted international vendors, which include identifying additions & removals for clinical review and providing update files to our Analysis team and International vendors.
• Maintain the drug NDC to disease state crosswalk for Analysis department reporting
• Manage the AWP reports for new drug to market identification and price changes
• Maintain the Biosimilar drug list for Analysis reporting & auditing
• Provide updates, as needed, to all Clinical Services policy & procedures
• Help support client plan performance reviews clinical slides, as needed
• Support client issue resolution with PBIRx contracted vendors, as needed
• Support new client implementation for formulary, utilization management and drug list development & evaluation, testing claim review and post go-live claim evaluation
• Provide research & related support for the development of clinical news content.
• Provide meeting notes for biweekly Clinical meeting. 

Job Qualifications:

Required:

- Associate’s degree with 3 years of employment experience in a managed care or PBM organization working in an analytical role and/or clinical department.

- Bachelor’s degree with 1 or more years of employment experience in a managed care or PBM organization working in an analytical role and/or clinical department.

- Intermediate level knowledge of Microsoft Excel

- Experience working with data files

- Excellent written communication skills

- Intellectual curiosity – a willingness to ask questions and continuously learn

- Ability to organize and prioritize workload and continually meet time sensitive deadlines

- Responsive to internal or vendor requests

- Ability to work with others in a multi-task team environment as well work independently

- Ability to adapt to change through growth and new responsibilities.

- Strong sense of professionalism in dress, work ethic, and client deliverables

- Sense of personal pride in successful completion of projects

- Reliable and flexible; sense of humor 

Preferred:

- Bachelor’s Degree in a STEM major

- Certified pharmacy technician

- 3 or more years of employment experience in a managed care or PBM organization.

- Experience with Medispan’s drug classification system

Salary and Benefits:

Salary is negotiable based on background and experience. Benefits Medical, Dental, Vision, Disability, etc., 10-14 paid holidays, Summer Hours, PTO commensurate with experience, industry related conferences and educational conferences. 

PBIRx is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability, or protected veteran status.