Healthcare Payer Analytics SME

Confidential Company  •  San Francisco, CA and South San Francisco, CA

11 - 15 years experience  •  Biotech/Pharma

Salary depends on experience
Posted on 12/08/17 by Priyatham Kumar
San Francisco, CA
11 - 15 years experience
Salary depends on experience
Posted on 12/08/17 by Priyatham Kumar

Job Title: Healthcare Payer Analytics SME

Location: South San Francisco Position


1. Should have worked with Symphony Health Data and DRG (Decision Resources Group) Sets

2. Must have experience with PBM (Pharma Benefit management)

?3. Less technical ??More experience on Pharma

Job Summary

Our Client is seeking a Principal Consultant for our Life Sciences Consulting practice, who has the experience and deep understanding of the payer landscape with focus on competitive payer contracting for specialty drugs and can help our clients overcome the evolving market access challenges. As a lead consultant and subject matter expert, you will be a crucial leading member of a fast growing team focused on payer analytics solutions and consulting engagements.

You will be expected to lead delivery of client projects; provide leadership, coaching and direct supervision to project staff; build/nurture client relationships; and lead/participate in analytics solution development and innovation efforts. Working independently under limited supervision, you are expected to help plan, analyze, design, and develop business analytics solutions for complex business problems. This person will work very closely with both the Business and I.T., at all levels, to ensure successful delivery of solutions.


Position Requirements and Responsibilities

Qualification and Experience:

·         Experienced (10+ years) strategy consultant in Payer/PBM landscape and competitive intelligence & analysis.

·         Subject matter expertise in managed markets, payer and provider reimbursements, pricing and market access strategy for the biopharmaceutical industry.

·         A skilled consultant, experienced in qualitative research methods, analytical methods, leadership level meeting facilitation, and strategy development.

·         An experienced client engagement leader, able to build enduring client relationships and expand company presence in key accounts, and drive repeat business.

·         A flexible team player and who works confidently and persuasively in a multicultural environment

·         Effective leader able to manage individuals and teams in addition to working well collaboratively with peers both within and across business units.

·         Focused track record in the pharmaceutical industry, with strong insight into the commercial planning and pricing, reimbursement and access processes.

·         Ideally, masters or PhD within a relevant discipline (health economics, health policy)

Data and Concepts Understanding with Experience:

·         Solid knowledge of healthcare data (claims, EMR, registries) is required. Specifically for Symphony Health, Truven, Zitter, Fingertip Formulary, IMS, etc.

·         Experience with formulary and coverage policy data for infused products.

·         Experience working on healthcare systems (authorizations, membership, referrals, eligibility, provider, etc.) with understanding of medical terminology, PBM and payer concepts.

·         Demonstrate understanding of assumptions and the process used to develop them. Incorporate understanding of data sources in the recommendation and implementation of appropriate business decisions.

·         Experience with scientific, clinical and outcome research studies is highly desirable.

·         Understanding of regulatory compliance issues is preferred.


Consulting Skills:

·         Demonstrate a logical, rigorous, and analytical problem-solving approach, leading requirements gathering sessions and preparing and delivering client presentations and work products

·         Experience writing uses cases, user stories and acceptance criteria

·         Experience with external facing applications planning and design

·         Experience with Waterfall, Agile/Scrum and RUP project delivery methodologies

·         Communicate business findings and strategic recommendations to senior management.

·         Conduct and document complex business analysis

·         Ability to adapt to change, work independently, organize work effectively and take initiative in fast-paced work environment while managing multiple tasks and deliverables simultaneously

·         Become a thought leader and Subject Matter Expert (SME) for specific analytics driven business problems.

·         Skilled at analyzing complex issues and distilling concepts to clients

·         Able to proactively identify risks, and drive action to mitigate and resolve issues

·         Strong analytical and interpersonal communication skills, with the ability to work independently

·         Strong organizational skills and the ability to manage a vast array of information

·         Broad understanding of the role of data management, information flow, and data governance issues

·         Able to serve as a liaison between both business and technical teams to drive effective, timely solutions that fulfill both strategic and operational needs

·         Skilled at defining and documenting business processes and requirements for ongoing system enhancement initiatives

·         Firm sense of accountability, ownership for end-to-end project lifecycle

·         Excellent verbal, written and presentation skills, with the ability to interact efficiently with technical and non-technical groups


Technical Expertise:

·         Data Warehouse experience (design, development and/or implementation) is preferred.

·         Experience with data discovery, analytics and reporting tools preferred (e.g. SQL, Excel, Qlikview, Tableau, Spotfire)

·         Demonstrated advanced level analytical skills are required.

·         Statistical experience (SAS, R, WPS, Python) is desirable.

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