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

About Capital Rx

Capital Rx is a next-generation pharmacy benefits manager, overseeing prescription benefit plans on behalf of employers, unions, and government entities. Determined to transform an outdated model, Capital Rx’s mission is to change the way prescription benefits are priced and administered in the US, unlocking enduring social change. Through our platform approach, Capital Rx delivers data-driven insights and actionable strategies that reduce costs, while improving patient outcomes. Our commitment to innovation, technology, and service is the reason why Capital Rx is among the fastest-growing PBMs in the country.

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
• Support encounter and PDE submission process by analyzing complex encounter data issues using data from internal and external sources
• Analyzes business workflow and system needs for conversions and migrations to ensure that encounter, recovery, and cost savings regulations are met
• 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

Required Qualifications:

• 3+ years of healthcare data experience required
• 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 required
• 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: $75,000 - $95,000

This range represents the low and high end of the anticipated base salary range for the NY - based position. The actual base salary will depend on several factors such as: experience, knowledge, and skills, and if the location of the job changes.

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.