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UPMC Health Plan has an exciting opportunity for a Strategic Data Consultant position located in the Pharmacy Services department. This is a full time position working Monday through Friday daylight hours and will be a hybrid position. Must be located in the Pittsburgh area to be considered!

Strategic Data Consultant applies expert experience to produce in-depth reporting and analytics for the pharmacy department. Clients include internal business line leaders and insurance division executive management, as well as external constituents and vendor opportunities. The Strategic Data Consultant must have the ability to manage data set infrastructure, and other technical processes for integrating healthcare pharmacy data elements from disparate sources throughout the UPMC enterprise. Manage comprehensive strategic analysis of data and information for various UPMC Health Plan products and programs. This integration results in a layer of information that guides pharmacy activities including strategic analysis, trend management, and clinical program evaluation. To successfully perform the role, the strategy data consultant must be highly professional and understand the causes of financial & clinical trends and anomalies. The position requires the ability to articulate these opportunities to internal and external audiences, implement the solutions, and track and monitor progress. The Strategic Data Consultant will take a leadership role in the pharmacy analytic department and provide enhancement, development, documentation, and communication of strategic opportunities, program development, and business trend modeling for the pharmacy department.

An ideal candidate will possess advanced SQL skillsets and have experience working with pharmacy claims and financial data, drug rebate modeling, PBM contractual oversight, formulary analytical support, pharmacy vendor management, and/or pharmaceutical industry subject matter knowledge.

Responsibilities:

+ Ability to perform and display sophisticated analyses and then be able to explain this analysis to a non-technical audience of both internal and external customers including senior management. Develop data extraction and integration processes to support analysis, data science, clinical operations, and decision support activities.

+ Highly responsive to requests, the ability to prioritize and complete the requests as they come from multiple constituents. Knowledge and wherewithal to only release analysis that are completely vetted and consistent with previously approved financial statements.

+ Subject matter expert with regards to PBM financial metrics and reconciliation. The claims and the contractual metrics are evaluated monthly and adjusted to meet the needs of the business, the PBM and the marketplace dynamics.

+ Specialty reporting and clinical program evaluations support the total cost of care model and without the level of expertise in the analysis the cost of specialty care would not be managed efficiently.

+ Create and perform financial and clinical analyses, explains this analysis to a non-technical audience of both internal and external customers, including senior management and present the request in a purposefully manner that translate to all audiences.

+ Identify trends in expenses, pharmacy utilization, and medical drug utilization. Investigate variances and determines viable solutions to cost increases and quality issues. All processes developed are implemented and monitored effectively ensure the solutions are effective and ongoing.

+ Oversee and provide guidance to peers and serve as reference point for questions on day-to-day basis. She coordinates the orientation of new staff members and acts as an ongoing consultant to the data as a senior SME in pharmacy IDW data and medical drug spend.

+ Maintain policies and procedures of the team / department. All processes are well documented and cross trained within department.

+ Perform validation and ensure quality standards for data sets created by fellow team members.

+ Investigate data errors/variances and derive solutions with appropriate follow-up monitoring.

+ Make recommendations for optimal data extraction, manipulation, and integration methodologies based upon research and analysis.

+ Provide technical consultation and act as reference point to peers, other business areas, senior leadership and external customers.

+ Meet deadlines and turnaround times set by supervisor. (These deadlines will, at times, require the employee to work until the project is completed, meaning extended daily work hours, extended work weeks, or both.)

+ Maintain up-to-date information on status and effort related to each project.

Minimum:

+ Bachelor's degree in information systems, data management, healthcare management, business, or related field.

+ Master's or other advanced degree is preferred.

Prior Work Experience:

+ Minimum of five years of work experience in information technology, healthcare, business, or research is required.

+ Experience in health insurance or healthcare industry is preferred, but those with relevant experience in other industries may be considered.

+ Data and Technology experience and technical proficiency in SQL is required.

+ Experience with other programming languages used in data science (such as R) is valuable.

+ Extensive experience in other programming languages may be considered.

+ Experience with extraction and manipulation of large, complex data sets is required.

+ Experience managing/preparing data sets for use in analysis, modeling, or business operations is required.

+ Experience with Microsoft Office products (particularly Excel) is required.

+ Experience with data visualization tools (such as Tableau, QlikView, or PowerBI) is valuable.

Other Work Skills:

+ Intermediate-level problem-solving skills are required.

+ The ability to effectively communicate issues and results, verbally and in writing, is required.

+ The ability to use effective time management skills, including prioritization multiple tasks, is necessary for success.

+ Attention to detail is critically important in this role.

+ Ability to succeed in a fast-paced, ambiguous/fluid environment.

+ A strong customer/stakeholder focus is expected at all times.

+ The successful Analytics Data Integration Developer, Associate is a team player that displays professionalism at all times.

+ Ability to work extra hours if required.Licensure, Certifications, and Clearances:

+ Act 34

UPMC is an Equal Opportunity Employer/Disability/Veteran