Job Description
Position Summary:
The Sr Government Programs Operations Analyst under the direction of the team leaders will develop solutions to analyze, interpret, and report on a wide variety of data. This individual will analyze complex datasets to help garner critical insights that will be leveraged to make key business decisions. Additional responsibilities include – delivering recurring and ad-hoc reports, facilitating requirement gathering sessions, developing BI dashboards, establishing, and adhering to analytical best practices, and developing a repository of standard code templates to facilitate automation of deliverables. Will also collaborate with internal and external cross-functional teams (compliance, product, sales, marketing, underwriting, implementation, client services, and clinical operations) to design, refine, automate, and maintain operational capabilities.
Position Responsibilities:
Supports Capital-Rx in developing reports that present key performance metrics as defined by client and regulatory guidelines – Including but not limited to encounter and PDE submission metrics
Extracts and compiles various sources of data to produce insightful information
Prepares any reporting mandated by government and client request
Works with internal and external clients to research, develop, and document new standards to enhance reporting capabilities
Implements and uses analytical software to support the department in achieving goals as defined by executive leadership
Presents and communicates complex analytical findings in a clear and concise manner
Participates in user acceptance, and quality assurance testing of new application features and team deliverables
Supports root-cause-analysis and reporting of encounter data issues/errors by partnering with key stakeholders – Will also provide operationally support
Monitors for changes in reporting requirements and updates documentation accordingly - Identifies new opportunities for process developments and improvements
Proactively reviews business processes and data to develop subject matter expertise of processes supported by our team
Analyzes business workflow and system needs for conversions and migrations to ensure that encounter, recovery, and cost savings regulations are met
Prepares high-level user documentation and training materials as needed
Collaborates with compliance to interpret and translate government reporting requirements into actionable recommendations/output
Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.
Required Qualifications:
3+ years of healthcare data experience
3+ years of proven experience in government programs
3+ years of experience working with SQL, R, or Python
2+ years of experience working with pharmacy data
2+ years of experience working with business intelligence tools
Experience with Medicare(Part D), Medicaid, and/or Marketplace Pharmacy Data/Processes
Experience performing analyses on large sets of data
Knowledge of data management, statistics, modeling concepts
Experience working with cross-functional teams
Experience with Power BI or other data visualization tools
Ability to balance multiple complex projects simultaneously
Extremely flexible, highly organized, and able to shift priorities easily
Attention to detail & commitment to delivering high-quality work product
Experience with Medicare, Medicaid, and Government Exchange programs preferred
Base Salary: $80,000 To $100,000
Visa Sponsorship: Capital Rx does not provide sponsorship to any candidates. This includes, but is not limited to those that require H1-B, TN, OPT, etc. Candidates must have authorization to work in the US at the time of application and throughout employment.
This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and responsibilities as needed to best meet organizational goals.
About Capital Rx
Capital Rx is a health technology company providing claim administration and technology solutions for carriers, health plans, TPAs, employer groups, and government entities. As a public benefit corporation, Capital Rx is executing its mission to materially reduce healthcare costs as a full-service PBM and through the deployment of Judi®, the company’s cloud-native enterprise health platform. Judi connects every aspect of the healthcare 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 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.
