[Remote] Pharmacy Operations Analyst

Note: The job is a remote job and is open to candidates in USA. Pyramid Consulting, Inc. is recruiting for an unnamed healthcare client. The Pharmacy Operations Analyst analyzes pharmacy benefit and formulary requirements, coordinates implementations, documents coverage rules, and resolves implementation issues.

Responsibilities

• Analyze and interpret complex formulary and pharmacy benefit requirements to create operational specifications
• Review large formularies and implementation documents to identify changes and operational impacts
• Manage multiple implementations while ensuring compliance with client and regulatory deadlines
• Develop comprehensive documentation detailing formulary status, prior authorization requirements, and coverage restrictions
• Collaborate with pharmacists and operational stakeholders to ensure successful implementation of requirements
• Investigate and resolve implementation issues, maintaining audit-ready documentation

Skills

• 2+ years of experience in •pharmacy benefit management (PBM)•, health plan pharmacy operations, or related healthcare operations
• Strong analytical skills with the ability to evaluate large data sets and identify discrepancies
• Advanced proficiency in •Microsoft Excel•, including data reconciliation and analysis
• Experience with •Prior Authorization•, •Medicaid•, and •pharmacy claims•
• Excellent documentation, organizational, and project coordination skills
• Ability to communicate effectively with technical and clinical stakeholders
• State Medicaid PDL implementation experience
• Experience with drug database vendors such as •Medi-Span• or •First Databank•
• Familiarity with •SQL•, data analysis, or reporting platforms
• Pharmacy Technician certification
• Experience supporting audits or regulatory implementations

Benefits

• Health insurance (medical, dental, vision)
• 401(k) plan
• Paid sick leave (depending on work location)

Company Overview

Company H1B Sponsorship