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Company: Medical Mutual
Location: United States of America
Career Level: Associate
Industries: Banking, Insurance, Financial Services

Description

Note, this is a remote opportunityEastern Time Zones preferred.

 

Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.

Responsibilities

Pharmacy Data Analyst I

Under direct supervision, delivers analysis of data and reports for clients and internal staff that identify actionable opportunities to improve appropriate use of medical and pharmacy benefit drugs to lower total costs of care. Delivers analytic insights by conducting routine or standard quantitative analysis supporting strategic business decisions. Focuses on analytic deliverables and enhancements to existing analyses and reports. Assures all analysis and reports are reliable, valid, and credible. Primarily works indirectly with internal business customers.

·         Applies analytics strategy and approach including routine or basic processes and analyses to deliver meaningful and actionable results as it relates to drug data, analytics, and reporting for medical drug and pharmacy management for clients and internal staff. 

·         Combines data from the enterprise data warehouse, pharmacy operational systems, and vendor outputs to deliver actionable insights with direct oversight and guidance from leadership.

·         Publishes and communicates results in writing and verbally, ensuring timely and accurate reports are delivered to internal business partners with direction from leadership.

·         Creates documentation on all projects to ensure continuity and as a resource for future projects.

·         Supports data pulls and reviews as it pertains to internal and external audits and other projects of the Medicare Part D (pharmacy) and Part C (medical drug) programs as assigned by management.

·         Collaborates on the creation and maintenance of tools, procedures, workflow, and data dictionaries.

·         Performs other duties as assigned.

Pharmacy Data Analyst II

Under general supervision, delivers analysis of data and reports for clients and internal staff that identify actionable opportunities to improve appropriate use of medical and pharmacy benefit drugs to lower total costs of care. Delivers analytic insights by conducting routine or standard quantitative analysis supporting strategic business decisions. Focuses on analytic deliverables and enhancements to existing analyses and reports. Assures all analysis and reports are reliable, valid, and credible. Primarily works indirectly with internal business customers.

·         Implements analytics strategy and approach including routine to intermediate processes and analyses to deliver meaningful and actionable results as it relates to drug data, analytics, and reporting for medical drug and pharmacy management for clients and internal staff. 

·         Combines data from the enterprise data warehouse, pharmacy operational systems, and vendor outputs to deliver actionable insights with moderate to minimal level of guidance from leadership.

·         Publishes and communicates results in writing and verbally, ensuring timely and accurate reports are delivered to internal business partners with general direction from leadership.

·         Creates documentation on all projects to ensure continuity and as a resource for future projects.

·         Supports data pulls and reviews as it pertains to internal and external audits and other projects of the Medicare Part D (pharmacy) and Part C (medical drug) programs as assigned by management.

·         Collaborates on the creation and maintenance of tools, procedures, workflow, and data dictionaries.

·         Performs other duties as assigned.

Pharmacy Data Analyst III

Under limited supervision, designs and executes analysis of data and reports for clients and internal staff that identify actionable opportunities to improve appropriate use of medical and pharmacy benefit drugs to lower total costs of care. Develops new analytic deliverables and enhancements to existing analyses and reports. Assures all analysis and reports are reliable, valid, and credible.

·         Plans, develop, and implements drug data consultation, analytics, and reporting for medical drug and pharmacy management for clients and internal staff.  Creates and maintains a standard reporting package that reflects the Company's value to customers.  Acts as subject matter expert (SME) to internal customers with regard to the interpretation of drug data. Creates documentation on all projects to ensure continuity and as a resource for future projects.

·         Analyzes and interprets medical and pharmacy data and provides recommendations for financial and performance metrics. Collaborates with interdepartmental and cross departmental analysts to ensure prompt delivery of necessary analytics. Identifies and reports to leadership potential process improvement for analytical functions within Pharmacy Department.

·         Completes multiple data projects with competing deadlines.  Works with team and department leadership to prioritize deliverables and meet reporting deadlines (weekly, monthly, quarterly, or yearly.)  Coordinates with teammates to ensure deliverables are created efficiently. Tracks work and provides regular progress updates to team and department leadership, and internal and external stakeholders. 

·         Performs other duties as assigned.

Senior Pharmacy Data Analyst

Under minimal supervision, designs and executes analysis of data and reports for clients and internal staff that identify actionable opportunities to improve appropriate use of medical and pharmacy benefit drugs to lower total costs of care. Develops new analytic deliverables and enhancements to existing analyses and reports. Assures all analysis and reports are reliable, valid, and credible.

·         Develops and provides drug data consultation, analytics, and reporting for medical drug and pharmacy management for clients and internal staff. Creates and maintains a standard reporting package that reflects the Company's value to customers.  Acts as subject matter expert (SME) to internal customers with regard to the interpretation of drug data. Creates documentation on all projects to ensure continuity and as a resource for future projects.

·         Analyzes and interprets medical and pharmacy data and provides recommendations for financial and performance metrics. Collaborates with interdepartmental and cross departmental analysts to ensure prompt delivery of necessary analytics. Identifies potential process improvement for analytical functions within Pharmacy Department.

·         Manages multiple complex data projects with competing deadlines. Works with team and department leadership to prioritize deliverables and meet reporting deadlines (weekly, monthly, quarterly, or yearly.) Coordinates with teammates to ensure deliverables are created efficiently.  Tracks work and provides regular progress updates to team and department leadership, and internal and external stakeholders. 

·         Orients, trains, assists, and mentors more junior level staff.

·         Performs other duties as assigned.



Qualifications

Qualifications

Pharmacy Data Analyst I

·         Bachelor's Degree in statistics, public health, healthcare or business administration, or a related field required.

·         Up to 1 year of professional work or educational project experience in analyzing data and basic statistics, preferably pharmacy data.

·         Basic proficiency in data extraction and analytical programming languages (Python, R, SAS, SQL, Spark), data visualization (Power BI, Tableau) and other analytical tools.

·         Basic knowledge of a cloud-based analytics platform (Azure data bricks).

·         Basic to intermediate Microsoft Office skills (word processing, spreadsheets, database reporting, presentation graphics).

·         Good presentation skills; ability to put together brief deck displaying results.

·         Basic knowledge of data mining, reporting, and reconciliation techniques and methodologies (e.g., machine learning, AI, etc.).

·         Basic knowledge of the health insurance industry, and benefit and product designs.

·         Basic knowledge of pharmacy claims, medical data, clinical programs.

Pharmacy Data Analyst II

·         Bachelor's Degree in statistics, public health, healthcare or business administration, or a related field required.

·         2 years of experience as a Pharmacy Data Analyst or equivalent experience analyzing data and statistics, preferably pharmacy data.

·         Proficiency in data extraction and analytical programming languages (Python, R, SAS, SQL, Spark), data visualization (Power BI, Tableau) and other analytical tools.

·         Knowledge of a cloud-based analytics platform (Azure data bricks).

·         Intermediate Microsoft Office skills (word processing, spreadsheets, database reporting, presentation graphics).

·         Good presentation skills; ability to put together brief deck displaying results.

·         knowledge of data mining, reporting, and reconciliation techniques and methodologies (e.g., machine learning, AI, etc.).

·         Knowledge of the health insurance industry, and benefit and product designs.

·         Knowledge of pharmacy claims, medical data, clinical programs.

Pharmacy Data Analyst III

·         Bachelor's Degree in statistics, public health, healthcare or business administration, or a related field required. Master's Degree preferred.

·         3 years progressive experience as a Pharmacy Analyst in health insurance, pharmacy benefit management or a consulting firm, or equivalent experience in various aspects of the healthcare industry (e.g., medical/drug claims processing, provider contracting, medical/ drug policy, utilization management, and reimbursement).

·         SAS, Tableau, and/or Python Certification preferred.

·         Microsoft Excel Certification preferred.

·         Intermediate to advanced skills in data extraction and analytical programming languages (Python, R, SAS, SQL, Spark), and data visualization tools (Power BI, Tableau), and the ability to perform queries and retrieve data from multiple tables and/or sources.

·         Intermediate knowledge of a cloud-based analytics platform (Azure data bricks).

·         Good track record of success with analyzing clinical, claims, pharmacy, program and other administrative data. 

·         Solid knowledge of health insurance products and industry, including trends and drivers of medical or pharmacy drug utilization, cost, and quality, and application of that knowledge to drive strategic decision making.

·         Good project management skills.

·         Good business acumen.

·         Ability interacts with internal and external senior leaders.

Senior Pharmacy Data Analyst

·         Bachelor's Degree in statistics, public health, healthcare or business administration, or a related field required. Master's degree preferred.

·         5 years progressive experience as a Pharmacy Analyst in health insurance, pharmacy benefit management or a consulting firm, or equivalent experience in various aspects of the healthcare industry (e.g., medical/drug claims processing, provider contracting, medical/ drug policy, utilization management, and reimbursement).

·         SAS, Tableau, and/or Python Certification strongly preferred.

·         Microsoft Excel Certification preferred.

·         Advanced skills in data extraction and analytical programming languages (Python, R, SAS, SQL, Spark), and data visualization tools (Power BI, Tableau), and the ability to perform queries and retrieve data from multiple tables and/or sources.

·         Advanced knowledge of a cloud-based analytics platform (Azure data bricks).

·         Significant track record of success with analyzing clinical, claims, pharmacy, program, and other administrative data. 

·         Advanced knowledge of health insurance products and industry, including trends and drivers of medical or pharmacy drug utilization, cost, and quality, and application of that knowledge to drive strategic decision making.

·         Strong project management skills.

·         Strong business acumen.

·         Ability to interact with internal and external senior leaders.

Medical Mutual is looking to grow our team! We truly value and respect the talents and abilities of all of our employees. That's why we offer an exceptional package that includes:

A Great Place to Work:

  • We will provide the equipment you need for this role, including a laptop, monitors, keyboard, mouse and headset.
  • Whether you are working remote or in the office, employees have access to on-site fitness centers at many locations, or a gym membership reimbursement when there is no Medical Mutual facility available. Enjoy the use of weights, cardio machines, locker rooms, classes and more.
  • On-site cafeteria, serving hot breakfast and lunch, at the Brooklyn, OH headquarters.
  • Discounts at many places in and around town, just for being a Medical Mutual team member.
  • The opportunity to earn cash rewards for shopping with our customers.
  • Business casual attire, including jeans.

Excellent Benefits and Compensation:

  • Employee bonus program.
  • 401(k) with company match up to 4% and an additional company contribution.
  • Health Savings Account with a company matching contribution.
  • Excellent medical, dental, vision, life and disability insurance — insurance is what we do best, and we make affordable coverage for our team a priority.
  • Access to an Employee Assistance Program, which includes professional counseling, personal and professional coaching, self-help resources and assistance with work/life benefits.
  • Company holidays and up to 16 PTO days during the first year of employment with options to carry over unused PTO time.
  • After 120 days of service, parental leave for eligible employees who become parents through maternity, paternity or adoption.

An Investment in You:

  • Career development programs and classes.
  • Mentoring and coaching to help you advance in your career.
  • Tuition reimbursement up to $5,250 per year, the IRS maximum.
  • Diverse, inclusive and welcoming culture with Business Resource Groups.

About Medical Mutual:

Medical Mutual's status as a mutual company means we are owned by our policyholders, not stockholders, so we don't answer to Wall Street analysts or pay dividends to investors. Instead, we focus on developing products and services that allow us to better serve our customers and the communities around us.

There's a good chance you already know many of our Medical Mutual customers. As the official insurer of everything you love, we are trusted by businesses and nonprofit organizations throughout Ohio to provide high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement and individual plans. Our plans provide peace of mind to more than 1.2 million Ohioans.

We're not just one of the largest health insurance companies based in Ohio, we're also the longest running. Founded in 1934, we're proud of our rich history with the communities where we live and work.

We maintain a drug-free workplace and perform pre-employment substance abuse and nicotine testing.


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