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Job Summary

Indianapolis, IN
Other/Not Classified
Job Type
Full Time
Career Level
Experienced (Non-Manager)
Job Reference Code

PBM Pricing Strategy Director (Pharmacy Pricing, Trend & Cost of Care Analytics): any Anthem loca...

About the Job

Your Talent. Our Vision. At Anthem, Inc., it's a powerful combination, and the foundation upon which we're creating greater access to care for our members, greater value for our customers, and greater health for our communities. Join us and together we will drive the future of health care.

This is an exceptional opportunity to do innovative work that means more to you and those we serve at one of America's leading health benefits companies and a Fortune Top 50 Company.

PBM Pricing Strategy Director (Pharmacy Pricing, Trend & Cost of Care Analytics): any Anthem locations in GA, MO, VA, or OH - PS4564

The PBM Pricing Strategy Director is responsible for managing pricing and bid responses for new and renewal Medicaid markets and supporting pharmacy pricing related activities for the merger and acquisitions team. Analyzing data and developing recommendations related to Pharmacy cost of care and pharmacy trends for the Medicaid book of business. Act as the primary contact and go-to subject matter expert for a wide range of financial matters related to Medicaid pharmacy pricing, drug spend, and pharmacy networks.

Primary duties may include, but are not limited to:
  • Develop and manage pricing tools and support the pricing of new and renewal markets at the product level.
  • Provide pricing support and serve as Medicaid RFP subject matter expert.
  • Supports account management through a variety of ad-hoc financial and data analyses, including pricing performance across various networks, markets, and products, sensitivity analyses, formulary and market share analyses, savings projections, and a variety of ad-hoc reporting.
  • Research competitor and other market level information to produce comparative reports that detail performance relative to our markets and present to leadership.
  • Ability to extract and analyze large complex datasets to support cost of care and trend analytics.
  • May require taking business issue and devising best way to develop appropriate diagnostic and/or tracking data that will translate business requirements into usable decision support tools. May make recommendations based upon data analysis.
  • Evaluate proposed pharmacy initiatives and programs, identify key drivers and make recommendations to support decision making across Medicaid Health Plans
  • Supports multiple internal levels of management to evaluate pharmacy related issues and formulate effective actionable solutions.
  • Analyze and present actual vs forecasted pricing performance by market and product level to account management and leadership.
  • Evaluate opportunities leading to better pricing performance and potential cost saving initiatives.
  • Requires a BS/BA degree in related field;
  • 5-7 years pricing, trend and data analysis or related experience; or any combination of education and experience, which would provide an equivalent background.
  • Requires experience manipulating and processing datasets with proficiency in SQL and/or SAS, Access, and Excel.
  • Strong analytical, organizational and problem solving skills.
  • Pharmacy or healthcare industry experience preferred
  • Medicaid experience is preferred
  • MBA preferred
Anthem, Inc. is ranked as one of America's Most Admired Companies among health insurers by Fortune magazine and is a 2017 DiversityInc magazine Top 50 Company for Diversity. To learn more about our company and apply, please visit us at antheminc.com/careers. EOE. M/F/Disability/Veteran.

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