Pharmacy Data Architect-North Carolina - Georgia IT Inc.
North Carolina, GA
About the Job
Job Title : Pharmacy Data Architect
Location : North Carolina
Position Type : Contract
Rate : DOE W2/C2C/1099
Interview mode : Both Phone and In Person
US Citizen, Green Card and GC EAD Preferred
The primary purpose of this position is to ensure reliable and accurate analysis of data to facilitate the Pharmacy Benefit staff's ability to develop and implement projects to achieve established programmatic goals and objectives. Using public health knowledge and analytic expertise, activities of this position include the day to day operations around ensuring Pharmacy Benefit team access to SHP medical and prescription drug claims and enrollment data in a usable format; conducting queries for Pharmacy Benefit staff and other internal customers; providing guidance around formats and methodology for ad hoc and routine reporting; and analyzing reports and providing analytic support to Pharmacy Benefit team members. This position will report to Director, Pharmacy Benefits and the Director of Healthcare Analytics.
Responsibilities:
1. Understand and work with the multiple sources of data available to the State Health Plan, including medical (ICD-10, HCPCS, CPT-4 codes) and prescription drug claims (NDC-11, DAW codes, knowledge of drug databases) and eligibility data (effective dates, Medicare designation, HCINs). Utilize SAS to evaluate a wide array of data types and to perform analyses according to analysis plans (develop analysis plan). Upon request, assist in developing study methodology, determining sample sizes, manipulating complex databases, and tracking and evaluating patterns of care and outcomes.
2. Utilize data from the SAS data warehouse, vendors, and other internal and external sources to prepare a quarterly dashboard report on key metrics and predicative data modeling utilizing standalone prescription or medical claims data or integration of prescription and medical claims data which will inform the Pharmacy Benefit team of disease prevalence, utilization patterns, cost and quality metrics, and the development of predicative modeling processes.
3. Work with the Pharmacy Benefit team in providing the ad hoc reports required for benefit design, program management, development and monitoring. This could include additional in-depth analysis to determine incidents of, cause and effect within trend patterns observed in utilization and quality metrics. Interpret and translate data for the use of Pharmacy Benefit staff. Assist in designing and implementing monitoring oversight and evaluating plan design, formulary, and other initiatives developed and implemented by Pharmacy Benefit. Develop data collection instruments, collect required data, analyze, and report on decided upon process and outcome measures.
4. Review data and reports received from Vendors for validity and accuracy. Develop metric definitions for use by Vendors for consistency in data reports. Work with vendors to ensure consistent and reliable data flows and compliance with contractual obligations.
5. Participate in the development of methodology for calculations of Return on Investments (ROI) for plan benefit, formulary, and outcomes initiatives and other validation studies as needed.
6. Prepare and present data to internal and external stakeholders to guide strategic planning and to assist in monitoring progress towards strategic goals for Pharmacy Benefit.
7. Participate in data analyst, project, staff, and other meetings. Reports project progress and results to staff as needed.
8. Assist the Healthcare Analytics team in loading and testing the Pharmacy file loads into the SHP SAS Data Warehouse.
Required skills:
Nice to have:
Location : North Carolina
Position Type : Contract
Rate : DOE W2/C2C/1099
Interview mode : Both Phone and In Person
US Citizen, Green Card and GC EAD Preferred
The primary purpose of this position is to ensure reliable and accurate analysis of data to facilitate the Pharmacy Benefit staff's ability to develop and implement projects to achieve established programmatic goals and objectives. Using public health knowledge and analytic expertise, activities of this position include the day to day operations around ensuring Pharmacy Benefit team access to SHP medical and prescription drug claims and enrollment data in a usable format; conducting queries for Pharmacy Benefit staff and other internal customers; providing guidance around formats and methodology for ad hoc and routine reporting; and analyzing reports and providing analytic support to Pharmacy Benefit team members. This position will report to Director, Pharmacy Benefits and the Director of Healthcare Analytics.
Responsibilities:
1. Understand and work with the multiple sources of data available to the State Health Plan, including medical (ICD-10, HCPCS, CPT-4 codes) and prescription drug claims (NDC-11, DAW codes, knowledge of drug databases) and eligibility data (effective dates, Medicare designation, HCINs). Utilize SAS to evaluate a wide array of data types and to perform analyses according to analysis plans (develop analysis plan). Upon request, assist in developing study methodology, determining sample sizes, manipulating complex databases, and tracking and evaluating patterns of care and outcomes.
2. Utilize data from the SAS data warehouse, vendors, and other internal and external sources to prepare a quarterly dashboard report on key metrics and predicative data modeling utilizing standalone prescription or medical claims data or integration of prescription and medical claims data which will inform the Pharmacy Benefit team of disease prevalence, utilization patterns, cost and quality metrics, and the development of predicative modeling processes.
3. Work with the Pharmacy Benefit team in providing the ad hoc reports required for benefit design, program management, development and monitoring. This could include additional in-depth analysis to determine incidents of, cause and effect within trend patterns observed in utilization and quality metrics. Interpret and translate data for the use of Pharmacy Benefit staff. Assist in designing and implementing monitoring oversight and evaluating plan design, formulary, and other initiatives developed and implemented by Pharmacy Benefit. Develop data collection instruments, collect required data, analyze, and report on decided upon process and outcome measures.
4. Review data and reports received from Vendors for validity and accuracy. Develop metric definitions for use by Vendors for consistency in data reports. Work with vendors to ensure consistent and reliable data flows and compliance with contractual obligations.
5. Participate in the development of methodology for calculations of Return on Investments (ROI) for plan benefit, formulary, and outcomes initiatives and other validation studies as needed.
6. Prepare and present data to internal and external stakeholders to guide strategic planning and to assist in monitoring progress towards strategic goals for Pharmacy Benefit.
7. Participate in data analyst, project, staff, and other meetings. Reports project progress and results to staff as needed.
8. Assist the Healthcare Analytics team in loading and testing the Pharmacy file loads into the SHP SAS Data Warehouse.
Required skills:
- Master's Degree with emphasis in Public Health, PBM, Medical Management Systems, policy, program evaluation, statistics, or mathematics
- Experience in Healthcare Analytics or Research using SAS
- Writing factsheets and/or reports to a general public audience
- Strong Verbal and Written Communication Skills
- Proficiency with Microsoft Word
Nice to have:
- Microsoft Excel Spreadsheet Development (HLOOKUP, VLOOKUP, etc...)
Source : Georgia IT Inc.
