Working under the supervision of the Pharmacy Benefit Manager within the Bureau of Clinical Policy and Pharmacy and serves as an embedded resource on the pharmacy team.
Collaborate with a team of policy analysts, systems analysts, and clinical staff.
Assessment, monitoring, and ongoing maintenance of the drug reference file, which includes items covered under the pharmacy benefit and physician-administered drugs.
Serves primarily as an information and data analyst for the drug reference file and is responsible for the evaluation and ongoing management needed for accurate maintenance of the drug reference file and its functionality within Wisconsin’s Medicaid Management Information System (MMIS).
Ongoing activities include, but are not limited to, drug file data maintenance, analysis, research, and published data table maintenance.
Long-term activities include analyzing proposed changes to the drug reference file, developing alternatives, and proposing initiatives to improve the quality and efficiencies of the drug reference file.

6 or more years of experience as Business Analyst in Healthcare / Pharmacy Industry including 3 or more years of Medicaid and Medicare experience
Access database and Medicaid Pharmacy Benefit experience is a plus
Experience in Pharmacy reimbursement and understanding of drug coverage rules
Experience as a systems business analyst
Understanding of National drug codes (NDC)
Experience with drug claims processes

Senior Pharmacy Analyst

Key skills