[Hiring] Senior Pharmacy Data Analyst @WellSense Health Plan

Role Description

The Senior Pharmacy Data Analyst is a highly experienced and results-driven professional who plays a critical role in advancing the strategic objectives of the Pharmacy Department. Reporting to the Manager of Pharmacy Contracting and Reporting, this role operates with a high degree of autonomy and precision, leveraging deep expertise in pharmacy data analytics to deliver timely, actionable insights that drive operational excellence, regulatory compliance, and member health outcomes.

This individual is a master of data strategy—skilled in SAS, SQL, and advanced Microsoft tools—with a proven ability to architect complex data models, streamline reporting processes, and lead cross-functional initiatives. The Senior Analyst is responsible for developing and maintaining enterprise-level dashboards, overseeing regulatory submissions, and serving as the Pharmacy Data Steward, ensuring data integrity across systems and stakeholders.

With a minimum of 10 years of industry experience, the ideal candidate demonstrates exceptional analytical acumen, strategic foresight, and a commitment to producing high-quality deliverables efficiently and independently. This role demands a proactive leader who can translate complex data into compelling narratives, influence decision-making, and support cost-effective, data-driven pharmacy benefit management.

Our Investment in You:

• Full-time remote work
• Competitive salaries
• Excellent benefits

Qualifications

• Bachelor's degree in mathematics, information management, information systems, statistics, or an equivalent combination of education, training, and experience.
• Master's degree preferred.
• Minimum of 5 years of healthcare experience.
• Working knowledge of industry coding standards (e.g., generic product indicators, national drug codes, GPI’s, etc.).
• Minimum of 10 years in health insurance or with a PBM preferred.
• Extensive experience analyzing pharmacy claims data, formulary utilization, and drug cost trends.
• Familiarity with Medicare Part D data, STAR measures, and PDE submissions.

Requirements

• Successful completion of pre-employment background check.

Benefits

• Generous total compensation including benefits (medical, dental, vision, pharmacy).
• Merit increases.
• Flexible Spending Accounts.
• 403(b) savings matches.
• Paid time off.
• Career advancement opportunities.
• Resources to support employee and family wellbeing.

Key Functions/Responsibilities

• Develop and maintain a centralized dashboard for tracking pharmacy financial, operational, and clinical performance measures.
• Lead the process of regulatory reporting from development, validation, and submission collaborating with vendor partners to ensure data accuracy.
• Conduct data queries to monitor performance metrics, including Medicare STAR measures and quality improvement initiatives.
• Oversee PBM submission of all Part D claims to CMS as PDEs, identifying discrepancies and resolving errors to ensure 100% alignment.
• Assume the leadership role of Pharmacy Data Steward, advising cross-functional departments on data exchange specifications and serving as the subject matter expert for pharmacy data integrity.
• Support program processes by conducting User Acceptance Testing (UAT) and Quality Assurance (QA) testing.
• Collaborate with Pharmacy Department team members to identify, prioritize, and analyze customer needs and requests.
• Communicate effectively with internal cross-functional areas regarding pharmacy programs, formulary management, and pharmacy processes.
• Document workflows, perform analysis, and contribute to the design of systems to meet Pharmacy data needs.
• Deliver compelling presentations of findings and insights to internal stakeholders.
• Architect and implement intricate data models, data flows, and data integration processes.
• Engage collaboratively with cross-functional teams to identify optimization opportunities and develop innovative, data-driven solutions.
• Utilize leading BI tools such as Tableau or Power BI to create dynamic, visually compelling reports.
• Harness advanced tools such as Excel (including VBA), Python, or R to manipulate, analyze, and visualize data.
• Other duties as assigned.

Supervision Received

General direction and supervision by Manager of Pharmacy Contracting and Reporting.

Working Conditions and Physical Effort

• Ability to work OT during peak periods.
• Regular and reliable attendance is an essential function of the position.
• Work is normally performed in a typical interior/office work environment.
• No or very limited physical effort required. No or very limited exposure to physical risk.

Compensation Range

$77,000 - $111,500. This range offers an estimate based on the minimum job qualifications. However, our approach to determining base pay is comprehensive, and a broad range of factors is considered when making an offer.