[Hiring] Pharmacy Benefits Claims Analyst @Milliman

Role Description

We are looking for a Pharmacy Benefits Claims Analyst for our growing practice. Pharmacy benefits consulting work is, by nature, constantly changing and rarely routine. Applicants must have a deep understanding of pharmaceuticals and pharmacy benefits management (PBM) and feel comfortable working in an environment that requires attention to detail, collaboration, integrity, and adaptability.

In this role, you will:

• Design and conduct data-driven analyses using pharmacy claims data and complex modeling.
• Participate actively as a member of a multi-disciplinary analytics team, fostering the sharing of relevant information to help identify creative solutions to complex problems.
• Explain results of analyses to internal teams and provide valuable insights, both orally and in clear, concise client reports.
• Stay current on industry trends, regulations, and best practices in pharmacy benefit management.
• Contribute to the development of innovative methodologies and tools for pharmacy claims analytics.

Qualifications

• Minimum of 4 years of PBM or healthcare analytics experience including at least 2 years of experience specific to PBM analytics.
• Working knowledge of Microsoft Office suite, including proficiency in Excel and SQL Server.
• Proficiency working with and explaining movements in key PBM performance indicators and pharmacy claims statistics.
• Knowledge of formularies, pharmacy claims data and their nomenclatures, including NDC, AWP, PBM, WAC, etc.
• Knowledge of claims data and how these manifest in claim adjudication and downstream analyses.
• Strong time management and people management skills.
• Experience working in a dynamic environment, demonstrating adaptability and integrity.
• Strong technical communication skills, written and oral.
• Individual(s) must be legally authorized to work in the United States without the need for immigration support or sponsorship from Milliman now or in the future.

Benefits

• Medical, Dental and Vision – Coverage for employees, dependents, and domestic partners.
• Employee Assistance Program (EAP) – Confidential support for personal and work-related challenges.
• 401(k) Plan – Includes a company matching program and profit-sharing contributions.
• Discretionary Bonus Program – Recognizing employee contributions.
• Flexible Spending Accounts (FSA) – Pre-tax savings for dependent care, transportation, and eligible medical expenses.
• Paid Time Off (PTO) – Begins accruing on the first day of work. Full-time employees accrue 15 days per year, and employees working less than full-time accrue PTO on a prorated basis.
• Holidays – A minimum of 10 paid holidays per year.
• Family Building Benefits – Includes adoption and fertility assistance.
• Paid Parental Leave – Up to 12 weeks of paid leave for employees who meet eligibility criteria.
• Life Insurance & AD&D – 100% of premiums covered by Milliman.
• Short-Term and Long-Term Disability – Fully paid by Milliman.