Financial Analyst

RxBenefits is hiring! We are adding a Financial Analyst to our growing Revenue Operations team. The Analyst may work remotely or in our Birmingham, AL headquarters.

Position Overview

This Analyst will work in a team with the Strategic Pharmacy Analyst(s) (SPA) and Business Development Executive(s) (BDE) in the production of Financial Analyses, RFP responses, Comparable Analyses, and additional ad hoc reports in support of winning new business. The Analyst is responsible for ensuring that analyses/reports are accurate from the initial data receipt to the final review upon completion. This position offers a unique opportunity to collaborate with cross-functional teams, contribute to strategic decision-making, and drive the success of our organization.

Job Duties Include:

• Employ a consultative mindset with your SPA and BD team to gather complete information which includes new opportunity claims files, rebate reporting, plan designs, incumbent/renewal contracts, competing offers, group census’, and additional financial/clinical reporting.
• Perform deep dives into claims files provided, validating various data sets from multiple vendors and PBMs to ensure RxBenefits has the necessary requirements for our repricing process, formulary disruption analysis, clinical product modeling, and third-party product solutions.
• Be a Subject Matter Expert (SME) on the repricing process, results, and applicability to our modeling inclusive of discount guarantees, discount schedules, channel management, B/G classifications, specialty designations, rebate eligibility, and utilization trends.
• Be a Subject Matter Expert (SME) on the formulary disruption process, results, and applicability to our modeling inclusive of the incumbent designations, network disruption, RxBenefits designations, formulary exclusion impact, member impact, and formulary alternatives in connection with new prospect benefit plan designs.
• Apply the appropriate pricing schemes for each new business opportunity, understanding their applicability based on pricing models, formulary options, retail networks, maintenance program selections, specialty networks, fees, plan tier structure, new prospect member size, marketing agreements, broker commissions, drug utilization, and government regulations.
• Be a Subject Matter Expert (SME) on dozens of medical vendor/PBM contracts including utilization rules, B/G classification, discount applicability, rebate/fee credit applicability, contract term penalties, discount/rebate exclusions, UM terms, MCAP products, PAP, third party specialty arrangements, and their applicability on our modeling.
• Apply knowledge gained from repricing, formulary disruption, contract language, group size, claim utilization, clinical trend, and appropriate pricing scheme to deliver a custom RxBenefits Financial Analysis for every new prospect opportunity.
• Advise the SPA/BDE of any missing critical information that affects the accuracy and completeness of Financial Analyses, Comparative Analyses, RFP’s, and provide a recommended course of action as required.
• Assist the SPA and RFP writer in completing full RFPs, with a primary focus on completion of various ad hoc claim by claim reprices, formulary disruption, and pharmacy network reports.
• Maintain flexibility with constantly changing RxBenefits PBM drug lists and the effects this has on formulary tier changes, specialty designations, and LDD designations for new business opportunities.
• Assist the SPA in producing ad hoc reporting for BD, Brokers, and various RxBenefits team members to answer a broad range of questions around reprice, disruption, and member impacts for new opportunities with varying degrees of urgency to close business.
• Produce and verify new RxBenefits Product offerings using proprietary analytics systems to support the most up to date Financial and Clinical modeling for new business opportunities.
• Coordinate with Implementation to complete disruption analyses on sold groups and any other ad hoc reports needed.
• Utilize Salesforce to track open opportunities to completion and complete Pricing Reviews when necessary.

Key Success Measures:

• Quantifiable accuracy scores for Financial Analyses.
• Financial Analyses delivered promptly with varying deadlines.
• Completion of financial tabs of RFPs.
• Work independently with little to no supervision needed.
• Demonstrate knowledge of complex contracts and fine print language.
• Able to run complex pivot and vlookups to find detailed answers.

Required Skills / Experience:

• Four-year college degree from an accredited institution.
• Advanced MS Excel user (vlookups, pivot tables, file merging, etc.) required.
• Proven communication and relationship building skills required.
• Strong analytical and organizational skills required.
• Attention to detail and high-level time management skills required.
• PBM or Health industry experience preferred.
• Experience using SAS software is preferred.
• SFDC or other CRM experience preferred.

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