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The PBM Data Analyst is responsible for summarizing, analyzing, and interpreting pharmaceutical data to support strategic decision-making processes. This role focuses on enhancing the efficiency of pharmacy benefit programs while ensuring cost containment and delivering high-quality patient care.
A bachelor's degree in data science, statistics, healthcare management, or a related field is required, with a preference for an advanced degree. Candidates should have at least 2 years of experience in a data reporting or analysis role, preferably in healthcare analytics or pharmacy benefit management.
PBM Data Analyst REMOTE ROLE AND RESPONSIBILITIES The PBM Data Analyst at Liviniti is responsible for summarizing, analyzing, and interpreting pharmaceutical data to support strategic decision-making processes. The primary objective is to enhance the efficiency and effectiveness of pharmacy benefit programs while ensuring cost containment and delivering high-quality patient care. This role demands a keen eye for detail, strong analytical skills, and a collaborative approach to problem-solving. The following objectives further define the key job functions with a focus on the following: * Data Collection and Management * Gather and compile pharmacy and healthcare-related data from various sources, including claims, prescriptions, and pharmacy networks, ensuring comprehensive data capture. * Ensure data accuracy, completeness, and consistency through rigorous validation and cleaning processes to maintain high data quality standards. * Data Analysis and Reporting * Apply statistical and analytical techniques to identify trends, patterns, and anomalies in pharmaceutical claim data, providing actionable insights to support decision-making. * Perform cost-benefit analysis and cost-effectiveness studies for different medication and treatment options, helping to optimize financial and clinical outcomes. * Create reports, dashboards, and visualizations using tools like Domo, Tableau, or Power BI, effectively conveying insights and findings to various stakeholders, including senior leadership and cross-functional teams. * Compare data from different time periods and between different types of customers to better assess which plan actions are working and to what degree. * Predictive Modeling and Forecasting * Utilize predictive modeling and forecasting techniques to project future pharmacy benefit program costs and utilization patterns, aiding in strategic planning and budgeting. * Assess the impact of different benefit design changes on costs and patient outcomes, providing data-driven recommendations for program adjustments. * Compliance and Regulatory Support * Stay updated with healthcare regulations and ensure that pharmacy benefit programs comply with relevant laws and regulations, including those related to data privacy and security. * Assist in audits and compliance reporting as necessary, ensuring transparency and adherence to regulatory requirements. * Program Optimization and Collaboration * Provide data-driven recommendations for optimizing pharmacy benefit programs, including formulary management, prior authorization criteria, and cost-saving strategies. * Collaborate with cross-functional teams including Pharmacists, Account Managers, and IT professionals to implement recommended changes and enhance program performance. * Implement data validation processes to ensure data integrity and accuracy, troubleshooting data-related issues and discrepancies promptly. * Communication and Technical Skills * Communicate complex data analyses clearly and understandably, tailoring messages to diverse audiences, including technical and non-technical stakeholders. * Develop and Disseminate best practices for researching and answering our clients' questions about their benefit experiences and efficacies. * Proficiency in data analysis tools such as SQL, Python, or R, and familiarity with data visualization tools like Domo or Power BI, enabling robust and efficient data handling. * Familiarity with PBM software and pharmacy claims processing systems, ensuring seamless integration and analysis of diverse data sources. * Additional Responsibilities * Ability to maintain the confidentiality of sensitive medical information and knowledge of HIPAA Privacy and Security Rules * Abide by all obligations under HIPAA related to Protected Health Information (PHI). * If a HIPAA violation is discovered, whether individually or by another, you must report the violation to the Compliance Officer and/or Human Resources. * Attend, complete, and demonstrate competency in all required HIPAA Training offered by the company. * Flexibility to understand, appreciate, and embrace that this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities that are required of the employee. Duties, responsibilities, and activities may change, or new ones may be assigned at any time with or without notice. REQUIRED SKILLS AND COMPETENCIES * Strong analytical skills and proficiency in data analysis tools and programming languages, including SQL, Python, or R. * Understanding of pharmacy benefit terminology, formulary management, and medication pricing, providing a solid foundation for effective program analysis. * Previous experience in healthcare analytics, pharmacy benefit management, or a related field, with a preference for experience in healthcare data analysis. * Excellent communication and presentation skills, capable of conveying complex analyses clearly and persuasively. * Attention to detail and the ability to work independently and as part of a team, fostering a collaborative and precise work environment. WHAT WE HAVE TO OFFER Our benefits package is designed to keep our employees happy and healthy - physically, mentally and financially. * Medical, Dental, Vision insurance * Disability and Life insurance * Employee Assistance Program * Remote work options * Generous Paid-Time Off * Annual Reviews and Development Plans * Retirement Plan with company match immediately 100% vested POSITION TYPE AND EXPECTED HOURS OF WORK * Full-time/Salaried/Exempt. * Some flexibility in hours is allowed, but the employee must be available during the “core” work hours of 8:00 AM to 5:00 PM CT. We cover clients from the West to East Coast, work times must be adjusted to cover meetings in all time zones. Ability to work extended hours, weekends, and holidays pursuant to industry demands. TRAVEL * This position requires minimal travel. REQUIRED EDUCATION AND EXPERIENCE * Bachelor's degree in data science, statistics, healthcare management, or a related field; advanced degree preferred. * 2 years experience in data reporting or analysis role PREFERRED EDUCATION AND EXPERIENCE * Familiarity with pharmacy claims coding terminology preferred. * Degree or equivalent experience; preferably in a technology or technical business discipline. * Intermediate level knowledge with any of the following: SQL Server or other RDMS, SSRS, or Power BI. Liviniti, LLC and all entities provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, sex, national origin, age, disability, or genetics. In addition to federal law requirements, Liviniti complies with applicable state and local laws governing nondiscrimination in employment in every location in which the company has facilities. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation and training. Liviniti expressly prohibits any form of workplace harassment based on race, color, religion, gender, sexual orientation, gender identity or expression, national origin, age, genetic information, disability, or veteran status. Improper interference with the ability of Liviniti employees to perform their job duties may result in discipline up to and including discharge. EOE M/F/V/D
This job posting was last updated on 9/24/2025