Position Summary:

The Government Programs Analysis & Efficiencies Analyst will play a role in supporting the operational success of Medicare, Medicaid, and Exchange programs. Under the guidance of their manager, this analyst will utilize relational datasets to identify actionable insights that inform decisions and drive solutions that enhance efficiencies. The analyst's responsibilities include delivering recurring and ad-hoc reports, creating standardized code templates to automate deliverables, and detailed documentation of work products. Additionally, the analyst contributes to process optimization by designing scalable, automated solutions that streamline workflows and minimize manual intervention. Collaboration with cross-functional teams, including compliance, product, sales, marketing, underwriting, implementation, client services, and clinical operations, is crucial to ensure that analytical tools and operational capabilities align with both regulatory requirements and business objectives.

Position Responsibilities:

• Analyze relational datasets to identify trends, outliers, and opportunities for operational improvement across Medicare, Medicaid, and Exchange programs
• Support development and maintenance of recurring and ad-hoc reports and analytical tools to support data-driven decision-making
• Contribute to the creation and maintenance of standardized code template repository to help streamline report generation and automation of routine tasks
• Ensure analytical outputs align with regulatory requirements and business objectives by interpreting CMS and state guidance in partnership with internal subject matter experts.
• Support the development of scalable processes that enhance efficiency, accuracy, and responsiveness across government program operations
• Support in designing and implementing automated solutions to reduce manual effort and improve process scalability, accuracy, and efficiency
• Uses analytical software to support the department in achieving goals as defined by executive leadership
• Participate in requirements gathering sessions to understand business needs and translate them into actionable analytical deliverables
• Presents and communicates analytical findings in a clear and concise manner
• Supports root-cause-analysis and reporting of data issues/errors by partnering with key stakeholders
• Participates in user acceptance, and quality assurance testing of new application features and team deliverables
• Prepares high-level user documentation (Including SOPs, Job Aids, and BRDs)
• Work with internal clients to research, develop, and document new standards to enhance reporting capabilities
• Collaborate with cross-functional teams-including compliance, product, sales, marketing, underwriting, implementation, client services, and clinical operations-to refine and enhance operational capabilities

Required Qualifications:

• 2+ years of healthcare data experience
• 2+ years of proven experience in government programs
• 2+ years of experience working with SQL
• Experience performing analyses on large sets of relational datasets
• Experience working with cross-functional teams
• Ability to balance multiple projects simultaneously
• Extremely flexible, highly organized, and able to shift priorities easily
• Self-motivated with the ability to problem solve with limited direction
• Attention to detail & commitment to delivering high-quality work product
• Excellent written and verbal communication skills

Preferred Qualifications:

• 2+ years of experience working with business intelligence tools
• 1+ year working with Python
• 1+ year of experience working with pharmacy data
• 1+ year of experience with Medicare (Part D), Medicaid, and/or Exchange Pharmacy Data/Processes
• Experience with Confluence, Jira, and other Atlassian product

New York, NY Salary Range

$76,000-$95,000 USD

Denver, CO Salary Range

$69,600-$87,000 USD

Charlotte, NC Salary Range

$63,200-$79,000 USD

All employees are responsible for adherence to the Capital Rx Code of Conduct including the reporting of non-compliance. 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.