Department

Job Title

Capital Rx is redefining the way prescriptions are priced and administered in the U.S. Capital Rx unlocks the pharmacy supply chain and reduces prescription costs for employer groups. By establishing a competitive marketplace for drug pricing, Capital Rx focuses its resources on deploying actionable strategies that improve plan performance and patient outcomes. The company's commitment to innovation, technology, and service is why Capital Rx is the fastest-growing pharmacy benefit manager in America.

Finance

Clinical Analytics Manager

Location: Remote (For Non-Local) or Hybrid (Local to NYC area)

Position Responsibilities:

• Experience working directly with pharmacy claims data, medical claims data, and other clinical metrics (i.e. lab values, PQA/Star/HEDIS measures, Medispan, etc)
• Collaborate with clinical teams to independently develop and run ad hoc and standard analytics and reporting deliverables, e.g., clinical program management, formulary strategy, utilization review (CDUR and RDUR), identify savings opportunities, and CMS compliance measures
• Integrate quantitative and qualitative analyses to provide strategic insights, e.g., program performance, utilization trends, disruption analyses, and savings projections
• Utilize best practices and apply knowledge of internal or external business issues, e.g., broad market trends, new-to-market drugs, FDA recalls, etc.
• Collaborate with vendors as needed to acquire and validate data to support reporting needs for clinical programs
• Create and maintain documentation of methodology behind clinical program reporting
• Translate data findings into strategic metrics and recommendations, disseminating findings to stakeholders from operational teams up to executive leaders
• Develop ad hoc and standard reports and dashboards to support internal and external analytics and reporting needs while identifying opportunities to support automation goals
• Collaborate with cross-functional teams on special projects and new product initiatives with a strong sense of ownership from end-to-end
• Advise on and implement process improvements and technical solutions with consideration to balancing ROI and development lifecycle timelines
• Review analysts’ work to ensure deliverables meet quality standards, including proper formatting, championing best practices with data and code hygiene, and coordinating with data modeling team to optimize query performance
• Responsible for the adherence to the Capital Rx Code of Conduct including reporting of noncompliance

Minimum Qualifications:

• Undergraduate bachelor’s degree, with record of strong academic performance in Computer Science, Actuarial Science, Statistics, or Economics preferred
• 5+ years of proven experience in data & analytics, benefits consulting, financial consulting, etc.
• 2+ years in PBM / health plan / healthcare / Medicare experience
• Experience building reports with BI tools such as Tableau
• Experience performing complex analyses on large sets of data
• Knowledge of data management, statistics, modeling
• Experience working with structured and unstructured data
• Skilled in SQL and Excel
• Experience or familiarity with Python or R
• Track record of leading cross-functional initiatives, driving high performance, meeting deadlines, and executing on deliverables
• Ability to balance multiple complex projects simultaneously, delivering in a timely manner
• Ability to work independently
• Exceptional written and verbal communication skills
• Experience in mentoring others
• Attention to detail & commitment to delivering high-quality work product
• Nice to have: knowledge of GitHub capabilities and be a key player in building out the Analytics workspace

Nothing in this position description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

About Capital Rx

Capital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advancing our nation’s electronic healthcare infrastructure to improve drug price visibility and patient outcomes. As a Certified B Corp™, Capital Rx is executing its mission through the deployment of JUDI®, the company’s cloud-native enterprise health platform, and a Single-Ledger Model™, which increases visibility and reduces variability in drug prices. JUDI connects every aspect of the pharmacy ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of pharmacy benefits and rebuilding trust in healthcare.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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