Job Description

Summary

• Samaritan Health Plans (SHP) provides health insurance options to Samaritan employees, community employers, and Medicare and Medicaid members. SHP operates a portfolio of health plan products under several different legal structures: InterCommunityHealth Plans, Inc. (IHN) is designated as a regional Coordinated Care Organization (CCO) for Medicaid beneficiaries; Samaritan Health Plans, Inc. offers Medicare Advantage, Commercial Large Group, and Commercial Large Group PPO and EPO plans; SHP is also the third-party administrator for Samaritan Health Services’ self-funded employee health benefit plan.

   

  As part of an Integrated Delivery System, Samaritan Health Plans is strategically and operationally aligned with Samaritan Health Services’ mission of Building Healthier Communities Together.

  This is a remote position in which we are able to employ in the following states: Alabama, Alaska, Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Pennsylvania, Rhode Island, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin

• The Senior Business Analyst provides analytics support to the Pharmacy Department as a primary function. This role acts as a liaison among stakeholders to elicit, analyze, communicate, and validate requirements in supporting pharmacy strategic and operational processes. The analyst understands business problems and opportunities in the context of the requirements and industry trends, recommends, and implements analytical solutions that enable the department achieve its goals. The candidate must have a working knowledge of pharmacy claims data, prescription drug events (PDE), industry drug databases, pharmacy financial data, and formulary data. They should also possess strong system skills including the ability to design and create moderate to complex queries of health care data, including data sets between the Health Plans and its PBM. This role will serve as a subject matter expert on rebate, pharmacy claims, and pharmacy data analytics, and oversee the PBM contract performance from a data perspective. They will also provide support for the Health Plans Clinical Services Division as assigned.

•  

• EXPERIENCE/EDUCATION/QUALIFICATIONS

  • Bachelor’s degree required. Master’s degree preferred.

  • Four (4) years business analysis and/or business systems analysis project coordination related experience required. A Master’s degree in a related field may be substituted for two (2) years experience.

  • Experience working on large scale projects as well as handling day-to-day operational requests from the business required.

  • Advanced experience and/or training in SQL and Microsoft Excel required.

  • Pharmacy data knowledge strongly preferred 

  • Health plans experience preferred 

•  

• KNOWLEDGE/SKILLS/ABILITIES

  • Effective written and verbal communication skills to perform group presentations, tactfully discuss issues, and listen to and understand concepts, rules and procedures. Ability to work with all levels within the organization, facilitate communication, and effectively document related activities.

  • Ability to identify complex problems, review related information, employ creativity and alternative thinking to develop and evaluate options and implement solutions.

•  

• PHYSICAL DEMANDS

  • Rarely (1 - 10% of the time)	Occasionally (11 - 33% of the time)	Frequently (34 - 66% of the time)	Continually (67 – 100% of the time)
    CLIMB - STAIRS LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs LIFT (Knee to chest: 24"-54") 0 – 20 Lbs LIFT (Waist to Eye: up to 54") 0 - 20 Lbs CARRY 1-handed, 0 - 20 pounds BEND FORWARD at waist KNEEL (on knees)	STAND WALK – LEVEL SURFACE ROTATE TRUNK Standing REACH - Upward PUSH (0 - 20 pounds force) PULL (0 - 20 pounds force)	SIT CARRY 2-handed, 0 - 20 pounds ROTATE TRUNK Sitting REACH - Forward	MANUAL DEXTERITY Hands/wrists FINGER DEXTERITY PINCH Fingers GRASP Hand/Fist

Job Tags

Similar Jobs