Qureos Mentor

Medical Mutual of Ohio

<div>Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance companies based in Ohio. We provide peace of mind to more than 1.2 million members through our high-quality health, life, disability, dental, vision and indemnity plans. We offer fully insured and self-funded group coverage, including stop loss, as well as Medicare Advantage, Medicare Supplement, and individual plans.

**This position requires you to work onsite in Brooklyn, OH. on a hybrid basis.

Pharmacy Data Analyst I

Job Summary:

Under direct supervision, delivers analysis of data and reports for clients and internal staff that identify actionable opportunities to improve appropriate use of medical and pharmacy benefit drugs to lower total costs of care. Delivers analytic insights by conducting routine or standard quantitative analysis supporting strategic business decisions. Focuses on analytic deliverables and enhancements to existing analyses and reports. Assures all analysis and reports are reliable, valid, and credible. Primarily works indirectly with internal business customers.

Responsibilities:
<ul>
<li>Applies analytics strategy and approach including routine or basic processes and analyses to deliver meaningful and actionable results as it relates to drug data, analytics, and reporting for medical drug and pharmacy management for clients and internal staff.</li>
<li>Combines data from the enterprise data warehouse, pharmacy operational systems, and vendor outputs to deliver actionable insights with direct oversight and guidance from leadership.</li>
<li>Publishes and communicates results in writing and verbally, ensuring timely and accurate reports are delivered to internal business partners.</li>
<li>Creates documentation on all projects to ensure continuity and as a resource for future projects.</li>
<li>Participates in internal and external audits and other projects of the Medicare Part D (pharmacy) and Part C (medical drug) programs as assigned by management.</li>
<li>Collaborates on the creation and maintenance of tools, procedures, workflow, and data dictionaries.</li>
<li>Performs other duties as assigned.</li>
</ul>
Qualifications:

Education and Experience:
<ul>
<li>Bachelor&rsquo;s Degree in statistics, public health, healthcare or business administration, or a related field required.</li>
<li>Up to 1 year of professional work or educational project experience in analyzing data and basic statistics, preferably pharmacy data.</li>
</ul>
Professional Certification(s):
<ul>
<li>NA</li>
</ul>
Technical Skills and Knowledge:
<ul>
<li>Basic proficiency in data extraction and analytical programming languages (Python, R, SAS, SQL, Spark), data visualization (Power BI, Tableau) and other analytical tools</li>
<li>Basic knowledge of a cloud-based analytics platform (Azure databricks).</li>
<li>Basic to intermediate Microsoft Office skills (word processing, spreadsheets, database reporting, presentation graphics).</li>
<li>Good presentation skills; ability to put together brief deck displaying results.</li>
<li>Basic knowledge of data mining, reporting, and reconciliation techniques and methodologies (e.g., machine learning, AI, etc.)</li>
<li>Basic knowledge of the health insurance industry, and benefit and product designs.</li>
<li>Basic knowledge of pharmacy claims, medical data, clinical programs.</li>
</ul>
Pharmacy Data Analyst II

Job Summary:
Under general supervision, delivers analysis of data and reports for clients and internal staff that identify actionable opportunities to improve appropriate use of medical and pharmacy benefit drugs to lower total costs of care. Delivers analytic insights by conducting routine or standard quantitative analysis supporting strategic business decisions. Focuses on analytic deliverables and enhancements to existing analyses and reports. Assures all analysis and reports are reliable, valid, and credible. Primarily works indirectly with internal business customers.

Responsibilities:
<ul>
<li>Implements analytics strategy and approach including routine to intermediate processes and analyses to deliver meaningful and actionable results as it relates to drug data, analytics, and reporting for medical drug and pharmacy management for clients and internal staff. Combines data from the enterprise data warehouse, pharmacy operational systems, and vendor outputs to deliver actionable insights with moderate to minimal level of guidance from leadership.</li>
<li>Publishes and communicates results in writing and verbally, ensuring timely and accurate reports are delivered to internal business partners with general direction from leadership.</li>
<li>Creates documentation on all projects to ensure continuity and as a resource for future projects.</li>
<li>Supports data pulls and reviews as it pertains to internal and external audits and other projects of the Medicare Part D (pharmacy) and Part C (medical drug) programs as assigned by management.</li>
<li>Collaborates on the creation and maintenance of tools, procedures, workflow, and data dictionaries.</li>
<li>Performs other duties as assigned.</li>
</ul>
Qualifications:

Education and Experience:
<ul>
<li>Bachelor&rsquo;s Degree in statistics, public health, healthcare or business administration, or a related field required.</li>
<li>2 years of experience as a Pharmacy Data Analyst or equivalent experience analyzing data and statistics, preferably pharmacy data.</li>
</ul>
Professional Certification(s):
<ul>
<li>NA</li>
</ul>
Technical Skills and Knowledge:
<ul>
<li>Proficiency in data extraction and analytical programming languages (Python, R, SAS, SQL, Spark), data visualization (Power BI, Tableau) and other analytical tools.</li>
<li>Knowledge of a cloud-based analytics platform (Azure databricks).</li>
<li>Intermediate Microsoft Office skills (word processing, spreadsheets, database reporting, presentation graphics).</li>
<li>Good presentation skills; ability to put together brief deck displaying results.</li>
<li>Knowledge of data mining, reporting, and reconciliation techniques and methodologies (e.g., machine learning, AI, etc.).</li>
<li>Knowledge of the health insurance industry, and benefit and product designs.</li>
<li>Knowledge of pharmacy claims, medical data, clinical programs.</li>
</ul>
Pharmacy Data Analyst III

Job Summary:
Under limited supervision, designs and executes analysis of data and reports for clients and internal staff that identify actionable opportunities to improve appropriate use of medical and pharmacy benefit drugs to lower total costs of care. Develops new analytic deliverables and enhancements to existing analyses and reports. Assures all analysis and reports are reliable, valid, and credible.

Responsibilities:
<ul>
<li>Plans, develops, and implements drug data consultation, analytics, and reporting for medical drug and pharmacy management for clients and internal staff. Creates and maintains a standard reporting package that reflects the Company&rsquo;s value to customers. Acts as subject matter expert (SME) to internal customers with regard to the interpretation of drug data. Creates documentation on all projects to ensure continuity and as a resource for future projects.</li>
<li>Analyzes and interprets medical and pharmacy data and provides recommendations for financial and performance metrics. Collaborates with interdepartmental and cross departmental analysts to ensure prompt delivery of necessary analytics. Identifies and reports to leadership potential process improvement for analytical functions within Pharmacy Department.</li>
<li>Completes multiple data projects with competing deadlines. Works with team and department leadership to prioritize deliverables and meet reporting deadlines (weekly, monthly, quarterly or yearly.) Coordinates with teammates to ensure deliverables are created efficiently. Tracks work and provides regular progress updates to team and department leadership, and internal and external stakeholders.</li>
<li>Performs other duties as assigned.</li>
</ul>
Qualifications:

Education and Experience:
<ul>
<li>Bachelor&rsquo;s Degree in statistics, public health, healthcare or business administration, or a related field required. Master&rsquo;s Degree preferred.</li>
<li>3 years progressive experience as a Pharmacy Analyst in health insurance, pharmacy benefit management or a consulting firm, or equivalent experience in various aspects of the healthcare industry (e.g., medical/drug claims processing, provider contracting, medical/ drug policy, utilization management, and reimbursement).</li>
</ul>
Professional Certification(s):
<ul>
<li>SAS, Tableau, and/or Python Certification preferred.</li>
<li>Microsoft Excel Certification preferred.</li>
</ul>
Technical Skills and Knowledge:
<ul>
<li>Intermediate to advanced skills in data extraction and analytical programming languages (Python, R, SAS, SQL, Spark), and data visualization tools (Power BI, Tableau), and the ability to perform queries and retrieve data from multiple tables and/or sources.</li>
<li>Intermediate knowledge of a cloud-based analytics platform (Azure databricks).</li>
<li>Good track record of success with analyzing clinical, claims, pharmacy, program and other administrative data.</li>
<li>Solid knowledge of health insurance products and industry, including trends and drivers of medical or pharmacy drug utilization, cost, and quality, and application of that knowledge to drive strategic decision making.</li>
<li>Good project management skills.</li>
<li>Good business acumen.</li>
<li>Ability to interact with internal and external senior leaders.</li>
</ul>
#LI-MM1</div>

Pharmacy Data Analyst

<div>Founded in 1934, Medical Mutual is the oldest and one of the largest health insurance
 
companies based in Ohio. We provide peace of mind to more than 1.2 million members
 
through our high-quality health, life, disability, dental, vision and indemnity plans. We offer
 
fully insured and self-funded group coverage, including stop loss, as well as Medicare
 
Advantage, Medicare Supplement, and individual plans.

Sr. Employer Group Consulting Analyst

Job Summary:
<ul>
<li>Design and execute analyses and reports for clients and their representatives that identify actionable opportunities to improve appropriate use of care, lower total costs of care, and increase receipt of high quality, evidence-based care. Primary responsibilities include, but are not limited to:</li>
<li>Examining and identifying distributions and drivers of population health, and health care utilization, costs and quality both within a population and across similar populations</li>
<li>Collaborating with Sales and Account Management, and clients and their representatives, to design, create and deliver analytic results that drive strategic decision making and demonstrate the value provided by products and services purchased</li>
<li>Synthesizing and communicating, in writing and verbally to technical and non-technical audiences, analytic results and conclusions including the business impacts of various courses of action</li>
<li>Tracking and prioritizing projects through coordination and negotiation with team and division leadership, Sales and Account Management staff, and clients and their representatives</li>
<li>Developing and maintaining relationships with key stakeholders</li>
<li>Contributing to the development of new analytic deliverables and enhancements to existing analyses and reports</li>
<li>Assuring all analyses and reports are reliable, valid and credible by performing quality checks of one's own work and serving as a reviewer of peers' deliverables</li>
<li>Formally coaching and mentoring junior team members</li>
<li>Developing and leading initiatives to address opportunities to improve efficiency and/or effectiveness of deliverables</li>
<li>Serving as a subject matter expert and trusted advisor to internal and external stakeholders</li>
</ul>
Responsibilities:
<ul>
<li>Analyzes data, creates reports, and presents results to clients and their representatives to inform strategic decision making. Directs stakeholders to appropriate analyses and value-added information beyond what is requested. Assesses population health status and illness burden, use of care, plan spend, and receipt of high-quality care consistent with evidence-based medicine guidelines. Ensures analytic results are insightful and actionable.</li>
<li>Collaborates with team and department leadership and internal stakeholders to gather, document, and execute analytic and reporting requirements. Explains technical details, relevance, and implications of analytic results to diverse audiences. Incorporates feedback to improve content and format of deliverables. Leads projects and may be dedicated to specific customers or customer segments. Develops relationships with clients and representatives.</li>
<li>Manages multiple projects with competing deadlines. Works with team and department leadership to prioritize deliverables. Coordinates with teammates to ensure deliverables are created efficiently. Tracks work and provide regular progress updates to team and department leadership, and internal and external stakeholders.</li>
<li>Contributes to development and enhancement of analytic deliverables. Actively participates in department and team meetings. Completes trainings to maintain and enhance knowledge, skills and abilities.</li>
<li>Performs other duties as assigned.</li>
</ul>
Qualifications:

Education and Experience:
<ul>
<li>Bachelor&rsquo;s degree in epidemiology, biostatistics, economics, public health, healthcare administration, nursing, or a related quantitative field.</li>
<li>Minimum of five (5) years of experience conducting analyses and delivering analytic results in a client-facing role with a health care insurance, consulting or delivery organization.</li>
<li>Master&rsquo;s degree preferred.</li>
</ul>
Professional Certification(s):
<ul>
<li>NA</li>
</ul>
Technical Skills and Knowledge:
<ul>
<li>Advanced experience and expertise in data extraction and analytical programming languages (SAS, SQL, Databricks, Python, R), and data visualization tools (PowerBI, Tableau, Looker), and the ability to perform queries and retrieve data from multilple tables and/or sources.</li>
<li>Track record of success with analyzing clinical, claims, pharmacy, program and other administrative data.</li>
<li>Intermediate to advanced knowledge of health insurance products and industry, including trends and drivers of population health status, utilization, costs, and quality.</li>
<li>Strong conceptual and hands-on knowledge of how data are captured, structured, and stored.</li>
<li>Advanced to expert knowledge of health plan operations, data sources, and data structures, including trends and drivers of quality, utilization, and costs. Comprehensive understanding of claim submissions and payment processes, reporting structures, database management, and financial concepts.</li>
<li>Demonstrated long-term success with communicating in writing, verbally and with delivering presentations.</li>
<li>Project management experience and expertise, a well-developed business sense, the ability to perform in a fast-paced environment, and comfort interacting with internal and external senior leaders are critical to success in the role.</li>
<li>Proven ability to assist with informally leading the work of others, influencing internal and external stakeholders, negotiating deliverables, and coaching teammates as a peer.</li>
<li>Work with minimal direction, initiate projects, and demonstrate significant flexibility to coordinate complex activities that are often subject to rapid or extensive changes.</li>
<li>Ability to lead conceptualization, development and execution of new deliverables and enhancements to existing deliverables.</li>
</ul>
Lead Employer Group Consulting Analyst

Job Summary:

Lead the design and execution of analyses and reports for clients and their representatives that identify actionable opportunities to improve appropriate use of care, lower total costs of care, and increase receipt of high quality, evidence-based care. Examining and identifying distributions and drivers of population health, and health care utilization, costs and quality both within a population and across similar populations. Serving as a collaborative and consultative partner with Sales and Account Management, and clients and their representatives, to design, create and deliver analytic results that drive strategic decision making and demonstrate the value provided by products and services purchased. Synthesizing and communicating, in writing and verbally to technical and non-technical audiences, analytic results and conclusions including the business impacts of various courses of action. Tracking and prioritizing projects through coordination and negotiation with team and division leadership, Sales and Account Management staff, and clients and their representatives. Developing and maintaining relationships with key stakeholders. Contributing to the development of new analytic deliverables and enhancements to existing analyses and reports. Assuring all analyses and reports are reliable, valid and credible by performing quality checks of one's own work and by leading peer review of others' deliverables. Formally coaching and mentoring junior team members. Conceptualizing, developing and leading initiatives to address opportunities to improve efficiency and/or effectiveness of deliverables.

Responsibilities:
<ul>
<li>Analyzes data, creates reports, and presents results to clients and their representatives to inform strategic decision making. Anticipates needs of clients and internal stakeholders and directs stakeholders to appropriate analyses and value-added information beyond what is requested. Assesses population health status and illness burden, use of care, plan spend, and receipt of high-quality care consistent with evidence-based medicine guidelines. Ensures analytic results are insightful and actionable. Brings expertise and experience to bear.</li>
<li>Collaborates with team and department leadership and internal stakeholders to gather, document and execute analytic and reporting requirements. Explains technical details, relevance and implications of analytic results to diverse audiences. Incorporates feedback to improve content and format of deliverables. Leads projects and is dedicated to specific customers and/or customer segments. Develops relationships with clients and representatives.</li>
<li>Manages multiple projects with competing deadlines. Works with team and department leadership to prioritize deliverables. Coordinates with teammates to ensure deliverables are created efficiently. Tracks work and provides regular progress updates to team and department leadership, and internal and external stakeholders. Assists junior teammates with developing project management skills.</li>
<li>Proposes and leads development and enhancement of analytic deliverables. Leads and actively participates in department and team meetings. Completes and leads trainings to maintain and enhance knowledge, skills and abilities.</li>
<li>Performs other duties as assigned.</li>
</ul>
Qualifications:

Education and Experience:
<ul>
<li>Bachelor&rsquo;s Degree in epidemiology, biostatistics, economics, public health, healthcare administration, nursing, or a related quantitative field.</li>
<li>Seven (7) or more years of experience conducting analyses and delivering analytic results in a client-facing role with a health care insurance, consulting or delivery organization.</li>
<li>Master&rsquo;s degree preferred.</li>
</ul>
Professional Certification(s):
<ul>
<li>NA</li>
</ul>
Technical Skills and Knowledge:
<ul>
<li>Advanced experience and expertise in data extraction and analytical programming languages (SAS, SQL, Databricks, Python, R), and data visualization tools (PowerBI, Tableau, Looker), and the ability to perform queries and retrieve data from multiple tables and/or sources.</li>
<li>Significant track record of success with analyzing clinical, claims, pharmacy, program and other administrative data.</li>
<li>Advanced knowledge of health insurance products and industry, including trends and drivers of population health status, utilization, costs and quality, and application of that knowledge to drive strategic decision making.</li>
<li>Strong conceptual and hands-on knowledge of how data are captured, structured, and stored.</li>
<li>Advanced to expert knowledge of health plan operations, data sources, and data structures, including trends and drivers of quality, utilization, and costs. Comprehensive understanding of claim submissions and payment processes, reporting structures, database management, and financial concepts.</li>
<li>Demonstrated long-term success with communicating in writing, verbally and with delivering presentations.</li>
<li>Project management experience and expertise, a well-developed business sense, the ability to perform in a fast-paced environment, and comfort interacting with internal and external senior leaders are critical to success in the role.</li>
<li>Proven ability to assist with informally leading the work of others, influencing internal and external stakeholders, negotiating deliverables, and coaching teammates as a peer.</li>
<li>Work with minimal direction, initiate projects, and demonstrate significant flexibility to coordinate complex activities that are often subject to rapid or extensive changes.</li>
<li>Ability to lead conceptualization, development and execution of new deliverables and enhancements to existing deliverables.</li>
</ul>
#LI-MM1</div>

Employer Group Consulting Analyst

Join Medical Mutual of Ohio and explore 2   exciting career opportunities. They're hiring for various roles with options for remote or on-site work. Apply today and become part of their innovative team.

Medical Mutual of Ohio

ABOUT_COMPANY

Pharmacy Data Analyst

Employer Group Consulting Analyst