Executive Director Payer Relations Analytics

Executive Director Payer Relations Analytics

Requirements

• 10 plus years of knowledge in relevant aspects of the PBM/Payer/Retail Pharmacy industry dynamics and landscape.
• Executive level consulting experience in translating business problems across disciplines into advanced analytic projects with measurable business value combined with ability and experience to work closely with the individual contributors to efficiently translate plans into reality.
• Demonstrated experience evaluating projects based on business value and ROI.
• Analytics experience within the retail and/or healthcare industries, with experience deploying capabilities across a wide range of business disciplines and creating solutions to a variety of problems.
• Ability to manage/mentor/develop team members and build a supportive, high performing culture.
• Proven ability to establish and maintain collaborative relationships with non-analytic business partners, including executive leadership, in order to elicit business needs and formulate, propose and refine technical solutions in order to meet the business needs and to drive efficiency and effectiveness improvements and business value.
• Excellent written and oral communication and data presentation skills, with ability to tailor the communication style to the right audience, from the analytic professional to the senior business leaders.
• Excellent project management skills with ability to lead and engage in multiple projects and initiatives and appropriately prioritize her/his own time as well as that of the direct reports.

Responsibilities

• Identify, explore and develop ideas of margin opportunity for Retail Pharmacy with a specific focus on areas within the PBM and Plan Sponsor space. Present recommendations to Sr leaders (SVP Payer Relations and SVP Retail Pharmacy), including options for implementation aligned with necessary internal stakeholders. Examples may include items such as brand DAW strategies, impact of contract language, network mix trends, Med D landscape implications, identifying sources of margin leakage vs expectations, etc.
• Enhance, maintain, and evolve a suite of reporting and analytics for use by the broader Payer Relations team to manage payer account performance vs expectations, identify trends, and understand key data points related to payers.
• Ownership of Retail Pharmacy profitability data infrastructure (Palantir Foundry), which is a ~$15M annual licensed data platform used across >200 business users for business case development and analytical insights.
• Develop and deploy tools that streamline analytics work within Retail Pharmacy. Coordinate across Retail pharmacy business partners, AB&C & IT to efficiently implement these tools.
• Manage team of approximately five individuals to accomplish these goals. Develop cross business unit expertise to enable quick project ideation and evaluation.

Preferred Qualifications

• Solid understanding of pharmacy economics, PBM reimbursement, patient/customer characteristics, and use of claim transaction data for business insights.
• Solid understanding and hands on experience with a variety of analytic processes and techniques, including health economics outcomes research, measurement methodologies development, hypothesis testing, statistical significance testing, modeling and data science.
• Solid understanding and hands on experience working with large data sources, particularly administrative claims and clinical program data, focusing on efficient data extraction from large databases, data manipulation, and setting up optimized summary data layers.