Job Description
Title: Senior Healthcare Informatics Consultant - Pharmacy
Location: Baton Rouge, LA (Remote)
Type: Contract
Overview:
- The Senior Healthcare Informatics Consultant Pharmacy consultant independently provides advanced analytics to support understanding and improvement of pharmacy benefit utilization, cost, quality, and clinical outcomes.
- This role develops analytic attributes related to pharmacy utilization management, drug cost optimization, formulary performance, medication adherence, and provider/member pharmacy engagement.
- In collaboration with Pharmacy, Clinical, Actuarial, Finance, and IT partners, this position 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.
Job Duties:
- Leads the selection and application of pharmacy focused analytic, evaluation, and BI methodologies to support business decisions and strategic planning
- Leverages pharmacy claims data, PBM feeds, EDW data sources, and non EDW datasets to deliver actionable insights
- Independently partners with business teams to define pharmacy analytics needs and develop solutions such as predictive models, dashboards, utilization analyses, and performance metrics
- Serves as a pharmacy analytics advisor on enterprise and cross functional initiatives
- Translates pharmacy business rules and policies into analytical models and reporting solutions, acting as a liaison between Pharmacy, Analytics, IT, and EIM teams
- Performs peer data quality reviews to ensure accuracy, completeness, and consistency of pharmacy analytics output
- Conducts advanced descriptive and statistical analyses related to drug utilization, adherence, cost drivers, and clinical outcomes
Required skills/qualifications
- 4 years of healthcare analytics experience, with pharmacy or PBM analytics experience strongly preferred
- 3 years' experience analyzing pharmacy claims, formulary performance, drug mix, utilization trends, rebates, and adherence metrics (PDC/MPR)
- 2 years' experience/advanced knowledge of SAS (including Enterprise Miner) preferred
- 3 years' experience with SQL, SAS, R, Python, Tableau, or similar analytic/visualization tools
Education
- Bachelor's degree in healthcare administration, pharmacy, public health, statistics, economics, analytics, computer science, or related field required
- Master's degree in a related field preferred
- Four years of related experience may substitute for a Bachelor's degree
Preferred skills
- 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
- Strong working knowledge of the U.S. healthcare system in a payer setting, with specific understanding of pharmacy benefits and PBM operations
- 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
- Pharmacy related quality metrics (HEDIS medication measures, STAR ratings)
- Knowledge of commercial and Medicare Advantage pharmacy optimization is a plus
- Excellent verbal and written communication skills
- Ability to translate complex pharmacy analytics into clear insights for executive, clinical, and technical audiences
Job Tags
Contract work, Remote work