RxBenefits is hiring! We are adding a Senior Financial Analyst to our growing Pricing Team, reporting to the Senior Manager, Financial Analytics!
Lead and participate in strategic and cross-functional meetings, ensuring alignment on business goals and operational efficiencies.
Oversee and prioritize workload distribution, ensuring optimal resource allocation and timely project execution.
Create, update, and standardize Standard Operating Procedures (SOPs) to ensure clarity and compliance across teams.
Create, maintain, and lead training initiatives including conducting training sessions, introducing new hires to job responsibilities, company policies, and procedures.
Organize, refresh, and enhance training materials to support ongoing employee development and knowledge retention.
Act as a dedicated mentor for 1-2 new hires/junior personnel, assisting them to adapt and grow into their roles, sharing insights, and best practices to help them succeed.
Own and manage template updates including pricing, formulary, legal, product, and formulary changes while also identifying opportunities to streamline and improve template design and functionality to enhance efficiency.
Perform accuracy reviews and additional support functions for the leadership team on RxBenefits Pricing updates across all partner PBMs.
Generate and deliver ad hoc reports across various business topics providing timely and accurate data insights to support decision-making processes and to drive organizational improvements across departments.
Be a Subject Matter Expert and dedicated resource for more complex and high-profile BD territories including Strategic, Hospital, and National.
Employ a consultative mindset with your SPA and BD team to gather complete information which includes new opportunity claims files, rebate reporting, plan designs, incumbent/renewal contracts, competing offers, group census', and additional financial/clinical reporting.
Perform deep dives into claims files provided, validating various data sets from multiple vendors and PBMs to ensure RxBenefits has the necessary requirements for our repricing process, formulary disruption analysis, clinical product modeling, and third-party product solutions.
Be a Subject Matter Expert (SME) on the repricing process, results, and applicability to our modeling inclusive of discount guarantees, discount schedules, channel management, B/G classifications, specialty designations, rebate eligibility, and utilization trends.
Be a Subject Matter Expert (SME) on the formulary disruption process, results, and applicability to our modeling inclusive of the incumbent designations, network disruption, RxBenefits designations, formulary exclusion impact, member impact, and formulary alternatives in connection with new prospect benefit plan designs.
Apply the appropriate pricing schemes for each new business opportunity, understanding their applicability based on pricing models, formulary options, retail networks, maintenance program selections, specialty networks, fees, plan tier structure, new prospect member size, marketing agreements, broker commissions, drug utilization, and government regulations.
Be a Subject Matter Expert (SME) on dozens of medical vendor/PBM contracts including utilization rules, B/G classification, discount applicability, rebate/fee credit applicability, contract term penalties, discount/rebate exclusions, UM terms, MCAP products, PAP, third party specialty arrangements, and their applicability on our modeling.
Apply knowledge gained from repricing, formulary disruption, contract language, group size, claim utilization, clinical trend, and appropriate pricing scheme to deliver a custom RxBenefits Financial Analysis for every new prospect opportunity.
Advise the SPA/BDE of any missing critical information that affects the accuracy and completeness of Financial Analyses, Comparative Analyses, RFP's, and provide a recommended course of action as required.
Assist the SPA and RFP writer in completing full RFPs, with a primary focus on completion of various ad hoc claim by claim reprices, formulary disruption, and pharmacy network reports.
Maintain flexibility with constantly changing RxBenefits PBM drug lists and the effects this has on formulary tier changes, specialty designations, and LDD designations for new business opportunities.
Assist the SPA in producing ad hoc reporting for BD, Brokers, and various RxBenefits team members to answer a broad range of questions around reprice, disruption, and member impacts for new opportunities with varying degrees of urgency to close business.
Produce and verify new RxBenefits Product offerings using proprietary analytics systems to support the most up to date Financial and Clinical modeling for new business opportunities.
Coordinate with Implementation to complete disruption analyses on sold groups and any other ad hoc reports needed.
Utilize Salesforce to track open opportunities to completion and complete Pricing Reviews when necessary.