- Implements new processes, process improvements, and best practices related to guarantee monitoring and ASO pass back activities.
- Creates and implements metrics and supports performance measures to establish performance objectives for revenue maximization.
- Creates tools and processes to monitor margin revenue and client retention.
- Monitors revenue performing below thresholds and implements necessary tasks to bring performance to or above targets.
- Implements pricing in the system related to margin.
- Supports the Pharmacy Services team in implementing future revenue, member expansion and growth capacity.
- Utilizes financial and actuarial modeling based on client and industry data to underwrite comprehensive pricing offers for PBM client contracts including:
- Underwriting pricing guarantees and pharmaceutical manufacturer rebates across pharmacy distribution channels (e.g., Retail)
- Underwriting Requests for Proposals (RFPs) requirements such as fees, credits, and performance guarantees
- Creating supporting financials such as profit and loss statements for internal reporting and measurement
- Reviews and completes financial sections of RFPs, market checks, and renewals to define the scope of PBM client support and forecast accurate cost assumptions into pricing offers.
- Reviews and provides approval for financial and pricing sections of legal agreements and negotiates preferred terms with client consulting firms and/or clients prior to contract execution
- Collaborates across the organization to provide recommendations on pricing and negotiation strategies to achieve revenue and profitability targets for new and renewal business.
- Strong Microsoft Excel modeling experience and comfort with writing formulas highly preferred.
- Underwriting experience helpful
- Experience with coding such as VBA, SQL, and/or other (e.g., SAS).
- MBA or other advanced degree.
- The salary range is the range Elevance Health in good faith believes is the range of possible compensation for this role at the time of this posting. This range may be modified in the future and actual compensation may vary from posting based on geographic location, work experience, education and/or skill level. Even within the range, the actual compensation will vary depending on the above factors as well as market/business considerations. No amount is considered to be wages or compensation until such amount is earned, vested, and determinable under the terms and conditions of the applicable policies and plans. The amount and availability of any bonus, commission, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole discretion unless and until paid and may be modified at the Company's sole discretion, consistent with the law.
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Senior Analyst, Pharmacy Benefit Manager Pricing - Middletown, United States - Elevance Health
Description
Senior Analyst, Pharmacy Benefit Manager Pricing & Underwriting
Location: Elevance Health operates in a Hybrid Workforce Strategy, providing various levels of flexibility while also ensuring that associates have opportunities to connect in-person. Unless in a designated virtual-eligible role and 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.
The Senior Analyst, Pharmacy Benefit Manager Pricing & Underwriting is responsible for Administrative Services Only (ASO) support functions.
How You Will Make an Impact:
Primary duties may include, but are not limited to:
Department-Specific Responsibilities:
Minimum Requirements:
Requires a BA/BS in Finance or related field and a minimum of 3 years of experience with Pharmacy Benefits Manager (PBM), data analysis; or any combination of education and experience, which would provide an equivalent background.
Preferred Skills, Capabilities and Experiences:
For candidates working in person or remotely in the below locations, the salary* range for this specific position is $75,360.00 to $135,648
Locations: California; Colorado; Hawaii; Nevada; New York; Washington State; Jersey City, NJ
In addition to your salary, Elevance Health offers benefits such as, a comprehensive benefits package, incentive and recognition programs, equity stock purchase and 401k contribution (all benefits are subject to eligibility requirements). The salary offered for this specific position is based on a number of legitimate, non-discriminatory factors set by the company. The company is fully committed to ensuring equal pay opportunities for equal work regardless of gender, race, or any other category protected by federal, state, and local pay equity laws .
