Pharmacy Benefits Analyst

Foundation Risk Partners, one of the fastest growing insurance brokerage and consulting firm in the US, is expanding its Pharmacy Benefits division, ARMSRx, with the addition of a Pharmacy Benefit Management (PBM) Analyst.

Job Summary:

We are seeing a motivated and detail-oriented PBM Analyst to join our dynamic analytics team. This team has developed automated comparison and annual reconciliation tools to support our clients and internal stakeholders. This is a fully remote position with a corporate office located in Florida.

Essential Functions:

• Produce savings analyses comparing PBM offers to determine the most cost-effective choice by utilizing claims data or pharmacy performance reports.
• Perform RFP analyses and report preparation while offering support to internal consultants.
• Perform plan design modeling for both existing and prospective clients.
• Perform requested ad hoc analysis based on client or broker requests.
• Utilize claims data to produce KPI, plan performance, and other ad hoc reports as requested.
• Perform invoice to claim data validations.
• Perform claims reviews which may include discount, dispensing fee, and rebate guarantees, benefit design, rebate contracts, performance guarantees, and claims repricing.
• Assist consultants with: data review for existing clients utilizing data and reports from various vendors, monitoring plan performance, identifying problem areas, as well as cost savings opportunities.
• Assist with the review of reports and presentations, and with presenting report of findings presentations.
• Monitor discount and rebate guarantees for our existing client base.
• Maintain monthly, quarterly, and annual reports.
• Communicate with the team and provide updates via email, video conference calls and/or phone calls.

Qualifications:

• Minimum of 5 years of experience in pharmacy benefit analytics, auditing, or a related role within the PBM or healthcare industry.
• Proficiency in Microsoft Excel (e.g., pivot tables, formulas, charts) and Microsoft Access (e.g., queries, data relationships).
• Experience working with large healthcare datasets, including claims data.
• Familiarity with pharmacy claims adjudication systems and PBM pricing models.
• Strong analytical and critical thinking skills with the ability to translate data into actionable insights.
• Ability to work independently in a remote, fast-paced environment with minimal supervision.
• Excellent verbal and written communication skills.

Preferred Qualifications:

• Working knowledge of rebate contracts, discount guarantees, and performance metrics in the pharmacy benefit space.
• Experience presenting analytical findings to internal and external stakeholders, including non-technical audiences.
• Knowledge of healthcare regulations, including HIPAA and transparency regulations.