2 days old
2017-12-072018-01-06

Analyst, Payer Operations

Walgreens
Deerfield, IL
  • Job Code
    52376BR
Analyst, Payer Operations at WALGREENS

Analyst, Payer Operations

Job ID 52376BR Location 1417 Lake Cook Rd , DEERFIELD, IL
Job Summary
Analyzes data to support the decision making on individual proposals and contracts related to pharmacy programs. Data analysis may include new product pricing, product portfolio, profitability of new opportunities with current and new clients, impacts of regulatory changes, capital analysis, and profit margin analysis. Assists in the development, implementation, on-going monitoring of strategies and tools to ensure 3rd party pharmacy programs are in compliance with contractual terms and conditions pertaining to designated product or service offering.

Job Responsibilities
  • Creates and maintains reports and portals to post, track, and report on initiatives, policies and procedures, departmental forms, and contracted policies and information within contracts.
  • Assists in the implementation processes of new third party plans and updates to ongoing third party plans; reviews and approves administrative paperwork prior to routing implementation information to the appropriate internal departments. Assists with tracking and resolving post-implementation issues related to contracts and pricing.
  • Reviews contracts and provides feedback to management regarding potential opportunities, immediate needs related to contracted terms and programs, resolves contract compliance issues and tracks financial impact. Escalates issues as necessary.
  • Assists in development of financial models to support management decision-making related to new product development, product portfolio analysis, profitability of new opportunities, capital investments, revenue models, profit margin analysis, and impact of regulatory changes. Presents findings to managements and makes recommendations that are market competitive and fit with Walgreens' strategy.
  • Performs ad hoc analysis and forecasts for internal management team and external customers.
  • Assist in the development of SOPs and provides guidance on processes, procedures, and functionality related to Contracts & Pricing.
  • Develops and maintains client relationships by providing services required to meet client needs while monitoring operational policies and procedures; reports gaps in client service and business issues of non-compliance to management.
  • Assists field personnel and management in resolving member issues


Walgreens, one of the nation's largest drugstore chains, is included in the Retail Pharmacy USA Division of Walgreens Boots Alliance, Inc., the first global pharmacy-led, health and wellbeing enterprise. More than 10 million customers interact with Walgreens each day in communities across America, using the most convenient, multichannel access to consumer goods and services and trusted, cost-effective pharmacy, health and wellness services and advice. Walgreens operates 8,175 drugstores with a presence in all 50 states, the District of Columbia, Puerto Rico and the U.S. Virgin Islands. Walgreens omnichannel business includes Walgreens.com. Approximately 400 Walgreens stores offer Healthcare Clinic or other provider retail clinic services.

As the neighborhood drugstore and retailer, our goal is to make health and happiness simpler, easier and within reach. And we remain a trusted wellness provider offering convenient access to important health services, such as immunizations and an array of pharmacy services that can help patients improve their health. To our team members, Walgreens represents a unique opportunity to excel in their careers in a welcoming and inclusive environment. We offer the chance to work in a truly supportive environment, and be a part of a progressive organization dedicated to the well-being of our customers, team members and the communities we all call home.

#LI-MM2

Basic Qualifications

  • Bachelor's Degree OR High School Diploma / GED and at least 3 years of experience in healthcare industry.
  • Experience pharmacy or medical terminology and various reimbursement methodologies.
  • Experience and/or understanding of with third party plan set-up and implementation.
  • Experience with analyzing and reporting data in order to identify issues, trends, or exceptions to drive improvement of results and find solutions.
  • Experience using time management skills such as prioritizing/organizing and tracking details and meeting deadlines of multiple projects with varying completion dates.
  • Experience providing customer service to internal and external customers, including meeting quality standards for services.
  • Intermediate level skill in Microsoft Excel (for example: using SUM function, setting borders, setting column width, inserting charts, using text wrap, sorting, setting headers and footers and/or print scaling).
  • Intermediate level skill in Microsoft PowerPoint (for example: ing a theme, formatting character spacing, inserting a picture, changing slide layout and theme colors, adding transitions, customizing slide numbers, changing chart style and/or formatting font).
  • Intermediate level skill in Microsoft Word (for example: inserting headers, page breaks, page numbers and tables and/or adjusting table columns).
  • Intermediate level skill in Microsoft Access (for example: designing and creating simple queries, modifying data types, adding dates, working with required fields and/or creating labels).
  • Understanding of project management and lean methodologies.
  • Willing to travel up to 10% of the time for business purposes (within state and out of state).

Preferred Qualifications

  • Advanced level skill in Microsoft Excel (for example: using AVERAGE function, merging and centering cells, printing centered page and/or creating a pivot table).
  • At least 2 years of experience implementing contracted Third Party programs in the healthcare industry.
  • At least 2 years of experience administering healthcare contracts.
  • At least 2 years of Payor and facility credentialing experience.
  • At least 2 years of medical reimbursement/fee schedule maintenance experience.
  • Infusion, Specialty Pharmacy, Retail Clinic, and/or Pharmacy Technician experience.
  • Experience using Walgreen proprietary systems (e.g. AS400, SIMS, POS, IC+).
  • At least 2 years of experience working in retail pharmacy operations.
  • Experience providing customer service to internal and external customers, including meeting quality standards and evaluation of customer satisfaction.

Categories

  • Administrative / Clerical
  • Customer Service
  • Healthcare
  • Retail / Wholesale

Featured Jobs

Career News

Share this job:

Analyst, Payer Operations

Walgreens
Deerfield, IL

Share this job

Analyst, Payer Operations

Walgreens
Deerfield, IL

Separate email addresses with commas

Enter valid email address for sender.

Join us to start saving your Favorite Jobs!

Sign In Create Account
Powered ByCareerCast