Pharmacy Analyst Resume Sample
Richmond Dibbert
67687 Madie Motorway,
Houston,
TX
+1 (555) 923 4777
Work Experience
Pharmacy Analyst Senior
01/2018
-
PRESENT
Philadelphia, PA
- Works with Pharmacy Benefit Manager and vendor partners on Part D operational and oversight functions of Signature HealthCare
- Coordinates with Compliance department on Part D oversight
- Performs ongoing monitoring functions (daily, weekly and monthly) of Part D internal and delegated activities to meet compliance requirements and identify risks, remediate issues. Tracks and report results. Includes, but not limited to: coverage determinations, appeals, grievances, and rejected/paid claims review
- Act as a liaison to address operational Part D issues including documenting issues, identifying owner, routing issue, gathering impact, and corrective action steps
- Works with Signature vendor partners to assist with Part D oversight activities
- Reviews Part D reporting prior to submission
- Completes and assists with Part D pharmacy benefit configuration, quality review and testing of Part D Benefits, Benefit Configuration in conjunction with Pharmacy Operations and other internal/external staff
- Completes posting, updating and monitoring of all Part D member and provider documentation available for print or on website
Pharmacy Analyst
07/2011
-
12/2017
Detroit, MI
- Coordinates with Stars team on Part D Star metrics
- Maintains knowledge of applicable current and proposed laws, regulations, and sub-regulatory guidance (e.g., CMS) applicable to Part D specifically and general knowledge of Medicare Advantage requirements
- Drafts and maintains policies and procedures, standard operating procedures, and work instructions
- Actively researches and stays current with requirements from CMS to ensure that Part D program is in compliance with government regulation. Develops and maintains a prioritized list of CMS and/or customer requirements for products
- Extensive knowledge of CMS requirements for MA plans, including Star Ratings, risk adjustment, Part D, etc. Understanding of National Committee for Quality Assurance (NCQA) requirements, as they pertain to MA, is highly desirable
- Track record of successfully leading multi-disciplinary teams in complex initiatives
- Work in a highly matrixed environment and establish effective leadership outside of immediate scope of authority
Division Pharmacy Analyst
02/2005
-
06/2011
Chicago, IL
- Partner with SME’s to develop realistic and innovative solutions
- Strong communication skills; able to clearly communicate complex information
- Leverages information technology and manual reporting systems to track and compare progress against performance goals
- Works well independently and within a team setting to achieve goals and meet deadlines
- Demonstrates initiative and the ability to multi-task and prioritize assignments
- Lead initiatives or projects
- Able to produce clear, concise process documentation
Education
Friends University
1999 - 2004
Bachelor's Degree in Computer Science
Professional Skills
- Excellent interpersonal skills; strong oral and written communication skills; attention to detail
- Strong Analytic Skills and Microsoft Excel skills,
- Advanced Microsoft Office skills and technical skills in database reporting tools such as SAS, SQL, TABLO, DB2 (QMF)
- Strong analytic and mathematical skills; highly experienced with Excel and associated functionality
- Strong interpersonal communication skills and experience with interacting with customers
- Act as a central resource to manage and monitor prior authorization and its validity prior to fill and provide a reason if prior authorization is denied
- PC Skills – demonstrates proficiency in Microsoft Office, Pharmacy Information System, Business Objects, purchasing vendor applications, and others as required
How to write Pharmacy Analyst Resume
Pharmacy Analyst role is responsible for excel, database, reporting, training, health, microsoft, research, finance, integration, purchasing.
To write great resume for pharmacy analyst job, your resume must include:
- Your contact information
- Work experience
- Education
- Skill listing
Contact Information For Pharmacy Analyst Resume
The section contact information is important in your pharmacy analyst resume. The recruiter has to be able to contact you ASAP if they like to offer you the job. This is why you need to provide your:
- First and last name
- Telephone number
Work Experience in Your Pharmacy Analyst Resume
The section work experience is an essential part of your pharmacy analyst resume. It’s the one thing the recruiter really cares about and pays the most attention to.
This section, however, is not just a list of your previous pharmacy analyst responsibilities. It's meant to present you as a wholesome candidate by showcasing your relevant accomplishments and should be tailored specifically to the particular pharmacy analyst position you're applying to.
The work experience section should be the detailed summary of your latest 3 or 4 positions.
Representative Pharmacy Analyst resume experience can include:
- Implementation / Execution: Makes appropriate decisions in the face of ambiguity. Anticipates and resolves barriers and constraints. Organizes and manages multiple priorities and/or projects using appropriate methodologies and tools
- Demonstrated ability to design, evaluate and interpret complex data sets.Strong analytic and problem solving skills
- Good communication skills, including the ability to tailor communication according to audience
- Problem solving and troubleshooting skills, especially as it relates to trends in vendor performance
- Analysis of ongoing Pharmacy Prior Authorization trending and associated medical cost savings by drug and therapeutic category
- Focus on achieving optimal member experience and continued viability of the pharmacy product portfolio
Education on a Pharmacy Analyst Resume
Make sure to make education a priority on your pharmacy analyst resume. If you’ve been working for a few years and have a few solid positions to show, put your education after your pharmacy analyst experience. For example, if you have a Ph.D in Neuroscience and a Master's in the same sphere, just list your Ph.D. Besides the doctorate, Master’s degrees go next, followed by Bachelor’s and finally, Associate’s degree.
Additional details to include:
- School you graduated from
- Major/ minor
- Year of graduation
- Location of school
These are the four additional pieces of information you should mention when listing your education on your resume.
Professional Skills in Pharmacy Analyst Resume
When listing skills on your pharmacy analyst resume, remember always to be honest about your level of ability. Include the Skills section after experience.
Present the most important skills in your resume, there's a list of typical pharmacy analyst skills:
- Interpersonal skills– able to work effectively with other employees and external parties
- PC Skills – demonstrates proficiency in MicrosoftOffice, PharmacyInformation System, Business Objects, purchasing vendor applications, and othersas requires
- Knowledge of database concepts and applications, proven quantitative and analytical skills
- Relevant, progressive experience in the area of specialization. Grandfathered experience requirements effective August 2016
- Administration skills, such as planning and organizing to maintain a productive work environment
- Basic Skills– able to perform mathematical calculations, balance and reconcile figures, punctuate properly, spell correctly and transcribe accurately
List of Typical Experience For a Pharmacy Analyst Resume
1
Experience For Willow / Pharmacy Analyst Resume
- Work with Clinical Business Analyst to understand the customer’s product-specific requirements and configuration and translate them to technical design specifications and data flow from which programs are developed and coded
- Pharmacy Technician experience and/or PBM/health plan experience
- Strong understanding and knowledge of medical/clinical and pharmacy terminology
- Regression and User Acceptance Testing experience
- Demonstrated reporting capabilities
2
Experience For Division Pharmacy Analyst Resume
- Process and research requests for prior authorizations and other requested exceptions
- Review and validation of all pharmacy cycle payment reports and authorize release of claims payments to all pharmacy network providers
- Proactively renews prior authorization in timely manner to provide continuity of care
- Provide and/or coordinate the analyses related to pharmacy program evaluation for cost-effectiveness and quality of care. This includes
- Identify and analyze product trends by supplier and SKU in support of consolidated distribution and formulary optimization activities
- Experience with benefit plans/structures/edits and/or formulary development processes
- Working knowledge of personal computers, and business software such as Microsoft Office
3
Experience For Clinical Pharmacy Analyst Resume
- Reporting and analysis of Pharmacy lock-in Program quality and financial impact
- Extensive working knowledge of pharmacy claims, preferably RxClaims system, including benefit coding and functionality
- Assure the ongoing high performance level of the overall department through continued knowledge acquisition and knowledge sharing with co-workers
- Identify contracting opportunities through data mining and new available Letters of Commitment
- Identify drug cost variances on a monthly basis and develop ongoing action plans to better manage those factors
4
Experience For Health & Benefits Pharmacy Analyst Resume
- Perform miscellaneous pharmacy purchasing cost analyses
- Analyze contract compliance and purchasing optimization opportunities
- Maintain monthly and ad hoc reporting
- Support all other pharmacy data analytics, financial management and reporting needs
- Relays all communications to patients and providers regarding authorization outcome
- .2. Act as primary contact and content owner for all program development modeling
- Performs miscellaneous pharmacy purchasing cost analysis
- Monitor trends in facility utilization of reverse distributors including SKU reduction opportunities
5
Experience For Pharmacy Analyst Senior Resume
- Analyze contract compliance and purchasing optimization opportunity
- Support analytics and dashboard/reporting needs for all division team members
- Comprehensive knowledge of all Microsoft Office applications, including Access, Word, Excel and PowerPoint
- Work with division pharmacy leadership on operational, clinical and financial analyses as needed
- Support PerformRx and AmeriHealth Caritas corporate, plan-level, and departmental strategies and goals by effectively applying both business knowledge and technical expertise to support business initiatives and solve business problems
6
Experience For Government Pharmacy Analyst Resume
- Develop and implement data-driven solutions to meet business requirements by producing data sets, reports, and analytics across a variety of subject matters – including, but not limited to, pharmacy management, account management, network management, contracting, pricing, finance, PerformRx clients and new business RFPs
- Ensure the accuracy and validity of both source data and results, and interpret results into recommendations
- Ensure the ongoing high performance level of the overall department through continued knowledge acquisition and knowledge sharing with co-workers
- Translate business requirements into production of both ad hoc and recurring reports and data sets
- Present findings to internal and external business customers
7
Experience For Pharmacy Analyst, Pharmacy Market Performance Resume
- Implement product/program designs and ensure quality standards, financial performance, and regulations are met
- Implement interventions that result in continuous measurable improvements
- Work collaboratively with business owners to identify areas where improvements are needed and to develop and monitor appropriate action plans to ensure a consistent focus on priority issues. General knowledge of key performance indicators (KPIs) and metrics
- Research and develop competitive pharmacy benefit offerings and ensure proper positioning in the marketplace
- Gather and analyze information, designs and test solutions to problems and formulates plans
8
Experience For Associate Pharmacy Analyst Resume
- Make decisions that refine and improve known practices or develops new approaches
- Work with multidisciplinary teams within Pharmacy Markets, other Organizational departments, and external vendors to ensure program effectiveness and general project management
- Establish routine informational exchanges, based upon proposed product designs, prospective goal setting, strategic planning and implementation activities
- Identify and articulate problems to management, steering committees and/or project sponsors
- Make independent contributions to projects as well as contributes and manages some small to medium projects, when applicable
- Work with Account Analyst to identify and assess organizational strategies such as work flow and systems/applications, in order to meet clients’ operational needs
- Create pricing and fee schedules as well as conduct audits to ensure accuracy
- Develop and implement data-driven solutions to meet business requirements by producing data sets, reports, and analytics across a variety of subject matters including, but not limited to, pharmacy management, account management, network management, contracting, pricing, finance, PerformRx clients and new business RFPs
9
Experience For Bilingual Pharmacy Analyst Resume
- Ensure the accuracy and validity of both source data and results and interpreting results into recommendations
- Translate business requirements into production of both ad hoc, and recurring reports and data sets
- Present findings to business internal and external customers
- High level expertise in Microsoft Office Suites required
- Researches, analyzes and interprets pharmacy statistical data. Identifies issues for audit or to be researched, determining affected areas, estimating the impact and leading the resolution
- Contributes to presentations to senior management
- Works with clinical positions or management to understand and interpret the financial impact of decisions made by retrieving and analyzing claim costs, revenue and/or other relevant data
- Participates in the implementation of new products and system enhancements by providing data and recommendations to assist in evaluating the impact of the proposed benefit, system or process changes
10
Experience For Senior Pharmacy Analyst Resume
- Independently manages the retrieval and analysis of data on multiple tasks or projects with little or no management involvement
- Pursues Excellence: Seeks out learning from experience, other people and various resources. Strives to develop and expand personal ability and performance. Continuously helps others upgrade their capability to contribute to Humana
- Performance analysis across all pharmacy brands
- Work closely with the Pharmacy Account team to identify opportunities and deliver solutions
- Researches, analyzes and interprets pharmacy statistical data. Identifies issues for audit or to be researched, determining affected areas, estimating the impact and leading the resolution
- Perform quality assurance checks on claim adjudication for compliance/oversight
- Troubleshoot and resolve drug claim issues for patients, physicians, pharmacies, and internal staff
- Work with vendors such as pharmacies, other mail order facilities, claims processors, etc. to resolve issues and improve processes
- Assist or Administer pharmacy benefit designs for contracted health plans and/or pharmacies (i.e. Health Alliance Plan/Pharmacy Advantage)
List of Typical Skills For a Pharmacy Analyst Resume
1
Skills For Willow / Pharmacy Analyst Resume
- Analyzes and interprets medical and pharmacy data and provides recommendations for financial and performance metrics. Collaborates with interdepartmental and crossdepartmental analysts to ensure prompt delivery of necessary analytics. Identifies potential process improvement for analytical functions within Pharmacy Department
- Pharmacy Claims experience including exposure to Drug Classification Systems: First Data Bank and/or Medi-Span
- Prioritize and handle multiple tasks in a demanding, fast paced work environment
- Progressive analytical experience with financial data required, preferably in healthcare pharmacy setting
- Experience with reporting software such as SAS, COGNOS, Tableau
- Experience with analyzing claims data
- Audit and/or testing experience
- Experience with data analytic tools such as Tableau
2
Skills For Division Pharmacy Analyst Resume
- Experience in SAS and / or R and / or Python
- Experience in Tableau and SQL
- Experience in FMCG within an analyst role would be highly advantageous
- Experience in Government and/or Regulatory
- Intermediate skill level of MS Access and Excel
3
Skills For Clinical Pharmacy Analyst Resume
- Progressive analytical experience with financial data required, preferably in healthcare
- Vendor management and analytics experience
- Develop and establish standardized processes and effective measurement, evaluation and improvement methods
- Performing outcomes tracking for campaigns
- Reporting and analysis of Pharmacy Key Performance Metrics (KPM)
4
Skills For Health & Benefits Pharmacy Analyst Resume
- Reviewing campaign requirements
- Reviewing CMS measure specifications
- Assist the consulting team in gathering, organizing and entering data into Excel spreadsheets to be used for various client projects
- Predictive Forecasting and Modeling, including financial and member impacts related to formulary development
- Support claim adjustment processes including identifying adjustment errors and correcting claims
- Maintain an in-depth knowledge of claims processing statistics and errors in claims processing related to authorizations
5
Skills For Pharmacy Analyst Senior Resume
- Establish a formal pharmacy trending reporting portfolio to be presented to the pharmacy management team and the actuarial team on a regular basis
- Facilitates meeting discussions, develops team agendas and action items for follow-up
- Identifies needs to develop new and innovative Pharmacy products, perform appropriate research/analyses, and evaluate feasibility of the administration and implementation of products
- Partners with business units to ensure compliance with governmental, contractual, and corporate guidelines, regulations, and policies and procedures. Continuously monitors regulatory changes, legislative efforts, industry trends, and/or contract changes
- Data Collection Analysis and Reporting Development
- Consult design develop and maintain Corporate and Division facing Report Cards and KPI’s
- Intermediate level knowledge of report writing and analysis of data
6
Skills For Government Pharmacy Analyst Resume
- Prefers working knowledge of SAS and SQL systems
- Clinical Pharmacy ad-hoc reporting needs
- Analysis and analytical deep dives from all areas of Humana Pharmacy Solutions, focusing on pharmacy data
- Monitors claim outcomes and formulary updates monthly. Supports benefit and integration testing
- Resolve system issues as they relate to production and claims processing and report findings for issue resolution
- Support the team by producing ad hoc reports and data support on demand
7
Skills For Pharmacy Analyst, Pharmacy Market Performance Resume
- Extract pharmacy claims data from the Enterprise Data Warehouse to identify and research claims processing issues related to incorrect authorizations
- Establish query and analysis of outcomes reporting for pharmacy clinical and financial (MCR) based programs
- Interpret patient treatment plans and medical notes for purposes of facilitating authorization requests
- Evaluate & communicate with nursing and physician staff any additional requirements or potential barriers to the treatment plan
- Conceptualize the impact of change and propose new methods of conducting business
- Maintains professional growth and development through self-directed learning activities and involvement in professional, civic, and community organizations
- Provides consultation and analytic support to assigned functional areas
8
Skills For Associate Pharmacy Analyst Resume
- Communication – communicates clearlyand concisely
- Judgment – makes decisions based upon job knowledge and experience. Considers all impacted areasin decision process. Seeks advice where applicable. Judgmentis sensible and reliable
- Policies and Procedures– articulates knowledgeand understanding of organizational policies, procedures and systems
- Communicationun – communicates clearly and concisely
- Knowledge of MS Office Tools (Excel, PowerPoint, Word)
- Progressive analytical or clinical experience in various aspects of the healthcare industry, preferably pharmacy, medical/drug claims processing, provider contracting, medical/ drug policy, utilization management, and reimbursement
- Comprehensive knowledge of the health industry, pharmacy clinical and benefit management, along with knowledge of pharmacy/medical terminology/coding
- Comprehensive knowledge of, and the ability to build analysis of various prescription benefit plan designs, formulary, and coverage management programs to compete in the marketplace to internal and external customers
- Analytical experience in financial analysis, healthcare pricing, network management, healthcare economics or related discipline
9
Skills For Bilingual Pharmacy Analyst Resume
- Exposure to IRI (Aztec), Tableau and Promax advantageous
- Knowledge of operations and workflow
- Current California Registered Pharmacy Technician Certificate
- Current National Pharmacy Technician Certification (PTCB)
- Proficiency with MS Office applications (Word, Excel, PowerPoint, Access)
- Utilize multiple applications simultaneously and be able to grasp new software programs easily
- : Health Insurance- Medicare Part D
- Outcomes Study design, development, and execution
- Root Cause Analysis and Deep Dives from all areas of Humana Pharmacy Solutions
10
Skills For Senior Pharmacy Analyst Resume
- Assist with the automation of processes
- Analyze the results and manage portions of projects
- Gather materials, benchmarking utilization data for a Request for Proposal (RFP) and interpret the meaning of the data and summarize the RFP responses in Excel or PowerPoint format for presentation to the client
- Gather and analyze data from the client and vendors to populate Excel spreadsheets used for developing cost projections and evaluation of vendor renewal proposals
- Gain an understanding of vendor/carrier markets, basic underwriting and financial skills, Health & Benefit products, services and technical tools, and intranet resources, by participating in training courses, online learning, or through learning from more experienced colleagues
- Develop benchmarking reports by gathering and analyzing pharmacy benefits data from a database, input it into a standardized template and compare a client's pharmacy plan information to other companies by industry or geography and assist client lead with resenting data
List of Typical Responsibilities For a Pharmacy Analyst Resume
1
Responsibilities For Willow / Pharmacy Analyst Resume
- Develop formal forecasting reports that can be utilized for purposes of actuarial modeling, forecasting and budgeting by finance personnel
- Assist with reporting and management of Pharmacy -pass-through- financial receivable process
- Support departmental Medication Therapy Management Program (MTM) via integration of pharmacy and medical claims and reporting of member outcomes
- Act as a resource for pharmacy benefit questions
- Produce and maintain assigned databases, reports, logs, summaries, and other documents as needed
2
Responsibilities For Division Pharmacy Analyst Resume
- Develop forward looking pharmacy forecasting models that account for high cost impact drugs in the pipeline, pending patent losses in key therapeutic categories as well as drug inflation and the Consumer Price Index (CPI)
- Daily reporting and analysis of all pharmacy financials by Line of Business (LOB)
- Development and analysis of Specialty Pharmacy specific cost modeling reports to establish impact of drug inflation, utilization, and population influence
- Assist with reconciliation of pharmacy encounter files and associated receivable balances
- Generate quarterly DMAHS and DOBI regulatory reports for review and sign-off
- Financial modeling of all therapeutic drug categories, and all newly FDA approved medications to support review and decision making by HNJH Pharmacy and Therapeutic Committee
3
Responsibilities For Clinical Pharmacy Analyst Resume
- Analyze pharmacy utilization patterns and call attention to significant changes in outpatient and medical based pharmacy drug utilization or expenditures requiring management attention
- Prefers knowledge of State of New Jersey Board of Pharmacy regulations and State Federal controlled substances regulation
- Proactively research and secure financial assistance for all patients
- Act as a resource to assist with education of new hires
- Create and maintain patient/member information in applicable systems
4
Responsibilities For Health & Benefits Pharmacy Analyst Resume
- Work independently and exercise sound judgment in interactions with physicians, payors, and patients and their families
- Perform reporting and analysis tasks to assist the pharmacy department to meet vendor oversight requirements for the PBM and Medication Therapy Management Program vendor. Work with appropriate pharmacy team members to track vendor issues to ensure appropriate resolution, and monitor and audit vendor performance
- .1. Work closely with pharmacy team to develop and track information needs
- .3. Perform QC on all models; and
- .4. Document processes and communicate results to appropriate pharmacy team members, other departments and leadership as needed
- Provide technical mastery and in-depth knowledge of large data structures to ensure that the pharmacy department's needs are being met on cross-departmental and cross-functional projects and initiatives
- Provides supervision and guidance to facility buyers to optimize purchasing practices for successful pharmacy inventory management
5
Responsibilities For Pharmacy Analyst Senior Resume
- Report pharmacy data to Network Health and Tufts Health Plan leadership and external agencies as necessary
- Represents the pharmacy program at applicable meetings and activities
- Ensure adherence to all applicable policies
- Prepare presentations, executive summaries, and other documentation to outline savings opportunities for facility and division management teams
- Works with facility DOP, Controller and CFO to identify drug cost variances on a monthly basis and develop ongoing action plan to better manage those factors that can be controlled at the facility level
- Assist in the development and implementation of financial data collection and measurement tools within the Supply Chain
6
Responsibilities For Government Pharmacy Analyst Resume
- Work with Division pharmacy leadership on operational, clinical and financial analysis as needed
- Prepare explanations of trends in Supply Chain performance and financial data
- Educate facility staff on how to run and analyze spend and utilization data
- Expert knowledge of Medicare Part D program requirements, specifically Chapter 6 of the Prescription Drug Benefit Manual (PDBM)
- Technical aptitude to serve as subject matter expert in technology development and automation
7
Responsibilities For Pharmacy Analyst, Pharmacy Market Performance Resume
- Handle multiple tasks, meet deadlines, and follow-up timely
- Knowledge of pharmacy claims
- Knowledge of Enterprise Data Warehouse
- Exercise sound judgment and raise issues to appropriate team members or management for resolution
- Interpret and explain the implications of planned changes to stakeholders
- Flexibility to change approach to fit audience
8
Responsibilities For Associate Pharmacy Analyst Resume
- Clinical Pharmacy adhocs
- Proficiency with RxNova
- Interact with members of the Mercer Marketplace and Managed Pharmacy Practice (MPP) client teams. Work closely with and leverage subject matter expertise of members of Mercer’s Managed Pharmacy team. Attend MPP trainings, both internal and carrier provided. In addition, utilize MPP team for thorough peer review, oversight, and escalations, as necessary
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