PBM Pricing Strategy Analyst Manager:
Responsible for Pharmacy Services pricing and Administrative Services Only (ASO) support functions.
Primary duties may include, but are not limited to:
- Implements new processes, process improvements, and best practices related to pricing, guarantee monitoring, and ASO pass back activities.
- Creates and implements metrics and supports performance measures to establish performance objectives for revenue maximization and pharmacy pricing.
- Creates tools and processes to monitor margin revenue, pricing accuracy, and client retention.
- Monitors revenue performing below thresholds and implements necessary tasks to bring performance to or above targets. Implements pricing in the system related to margin.
- Supports the Pharmacy Services team in implementing future revenue, member expansion and growth capacity.
- Assists with developing pharmacy pricing training to underwriters and updates to underwriting guidelines.
Department Specific Responsibilities:
- Utilizes financial and actuarial modeling based on client and industry data to underwrite comprehensive pricing offers for PBM client contracts including:
- Underwriting pricing guarantees and pharmaceutical manufacturer rebates across pharmacy distribution channels.
- Underwriting RFP requirements such as fees, credits, and performance guarantees
- Creating supporting financials such as profit and loss statements for internal reporting and measurement.
- Reviews and completes financial sections of Requests for Proposals (RFPs), market checks, and renewals to define the scope of PBM client support and forecast accurate cost assumptions into pricing offers.
- Collaborates across the organization to provide recommendations on pricing and negotiation strategies to achieve revenue and profitability targets for new and renewal business.
- Mentors and assists analysts/senior analysts colleagues on bid strategy and modeling.
- Requires a BA/BS in Finance or related field and a minimum of 5 years of experience with a Pharmacy Benefits Manager (PBM), pricing, data analysis; or any combination of education and experience, which would provide an equivalent background.
- MBA strongly preferred.
- Strong Microsoft Excel modeling experience and comfort with writing formulas highly preferred.
- Experience with VBA and/or SQL.
- Direct/indirect people management experience.
Please be advised that Elevance Health only accepts resumes from agencies that have a signed agreement with Elevance Health. Accordingly, Elevance Health is not obligated to pay referral fees to any agency that is not a party to an agreement with Elevance Health. Thus, any unsolicited resumes, including those submitted to hiring managers, are deemed to be the property of Elevance Health.
Be part of an Extraordinary Team
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. Previously known as Anthem, Inc., we have evolved into a company focused on whole health and updated our name to better reflect the direction the company is heading.
We are looking for leaders at all levels of the organization who are passionate about making an impact on our members and the communities we serve. You will thrive in a complex and collaborative environment where you take action and ownership to solve problems and lead change. Do you want to be part of a larger purpose and an evolving, high-performance culture that empowers you to make an impact?
We offer a range of market-competitive total rewards that include merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long term disability benefits, 401(k) +match, stock purchase plan, life insurance, wellness programs and financial education resources, to name a few.
The health of our associates and communities is a top priority for Elevance Health. We require all new candidates to become vaccinated against COVID-19. If you are not vaccinated, your offer will be rescinded unless you provide – and Elevance Health approves – a valid religious or medical explanation as to why you are not able to get vaccinated that Elevance Health is able to reasonably accommodate. Elevance Health will also follow all relevant federal, state and local laws.
Elevance Health has been named as a Fortune Great Place To Work in 2021, is ranked as one of the 2021 World’s Most Admired Companies among health insurers by Fortune magazine, and a Top 20 Fortune 500 Companies on Diversity and Inclusion. To learn more about our company and apply, please visit us at careers.ElevanceHealthinc.com. Elevance Health is an Equal Employment Opportunity employer and all qualified applicants will receive consideration for employment without regard to age, citizenship status, color, creed, disability, ethnicity, genetic information, gender (including gender identity and gender expression), marital status, national origin, race, religion, sex, sexual orientation, veteran status or any other status or condition protected by applicable federal, state, or local laws. Applicants who require accommodation to participate in the job application process may contact firstname.lastname@example.org for assistance.