Sr Analyst, Payer Compliance
- Manage Internal Claim Review process through continual maintenance of database, drug product list, and drug product error parameters.
- Analyze pre-dispensed prescription claim level data, build queries, maintain analyses, models, and dashboard to improve pharmacy claims accuracy to reduce potential audit chargebacks.
- Analyze and Identify patterns of post-dispensed prescription billing errors through analysis of prescription claim data, previous PBM audit findings, and drug product research. Effectively compile and communicate findings to leadership or stakeholders verbally, visually, and in writing.
- Collaborate with internal business units to propose and help put in place system enhancements to reduce prescription billing errors.
- Work with field leaders, audit companies, and PBM’s to proactively remediate and resolve audit issues as it pertains to claim billing, audits, and the drug dispensing process.
- Support special projects/initiatives, produce routine and ad hoc reports to compile audit statistics to aid in management decision making.
- Adaptable, open to change, and able to work in ambiguous situations and respond to new information or unexpected circumstances
EDUCATION REQUIREMENTS
Education Level
Area of Specialization (Marketing, Finance, Pharmacy, Engineering/IT, etc)
Required or Preferred
Bachelor Degree
Business, Finance, or Information Technology
Required
KNOWLEDGE, SKILLS AND ABILITIES
Knowledge, Skills and Abilities
Required or Preferred
Advanced Microsoft Excel experience including VBA and Macro code
Required
Experience with a computer programming language such as xml, SQL, HTML or PHP
Preferred
Tableau experience
Preferred
WORK EXPERIENCE
Experience
Areas of Experience (Pharmacy, Compliance, E-commerce, Retail, etc)
Required or Preferred
5 years of experience in Financial or Operational Analysis
Required
5 years of experience in PBM, Healthcare or Retail Pharmacy
Required
The typical starting pay range for this position is between $74,200 - $106,430 annually, although wages can very based on experience and geography.
If you want to make a difference, Rite Aid is the right place.
While Rite Aid is big, it still feels small — you and your work are never lost in the crowd. You know the leaders, and they recognize your impact. Teams are tightly knit and agile. Small groups, courageous enough to meet our goals in new ways. You can take your work, your team, or your business to the next level without being slowed down by a ton of process or layers of approval. For anyone with intent to grow, you can reinvent yourself in a new role or take on a new challenge while helping us reinvent Rite Aid and innovate our industry.
Wherever you work in the Rite Aid family, your diverse perspectives and fierce commitment enable us to deliver on the promise of ’whole health for life’ for communities around our country.
And that makes the biggest difference of all.
Rite Aid is on the front lines of delivering healthcare services and retail products to more than 1.6 million Americans each day.
Through our RxEvolution strategy, Rite Aid is re-imagining the neighborhood pharmacy as a destination for total health and wellness – the place where traditional medicine and alternative therapies come together in perfect harmony.
We believe in the power of pharmacy to provide trusted and accessible care that helps our customers go beyond healthy and get thriving. An essential part of our RxEvolution includes empowering our pharmacists to engage more with customers – while also updating our product mix to favor better-for-you and free-from options that our customers value.
Rite Aid Corporation is also proud to be one of the nation's leading drugstore chains. With approximately 2,500 stores in 19 states, we have a strong presence on both the East and West Coasts, employing more than 51,000 associates.
Fair Chance Act
Fair Chance Act Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
Pursuant to the Los Angeles Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.
Pursuant to the California Fair Chance Act, we will consider qualified applicants with a criminal history. You do not need to disclose your criminal history or participate in a background check until a conditional job offer is made to you. After making a conditional offer and running a background check, if we identify a conviction that is directly related to the job, you will be given the chance to explain the circumstances surrounding the conviction, provide mitigating evidence, or challenge the accuracy of the background report. Find out more about the Fair Chance Act by visiting the Civil Right’s Department Fair Chance Act webpage.
For more detailed information around city/state required notices, click here to access a list of disclosures.
New Jersey Law Against Discrimination (LAD)
The New Jersey Law Against Discrimination (LAD) prohibits unlawful employment discrimination based on an individual's race, creed, color, national origin, nationality, ancestry, age, sex (including pregnancy), familial status, marital/civil union status, religion, domestic partnership status, affectional or sexual orientation, gender identity and expression, atypical hereditary cellular or blood trait, genetic information, liability for military service, and mental or physical disability (including perceived disability, and AIDS and HIV status).