Company Overview:

Join us in our mission to transform healthcare! RxAdvance, now doing business as nirvanaHealth, is committed to bringing the art of possible to the payer and PBM industries, which is why we strive to invest in our employees throughout all stages of life. Success radiates through all levels of employees here, with competitive benefits, a strong focus on employee wellness, and optional education courses offered through UDEMY: we aim to support all aspects of employee growth.

Characterized by curiosity, innovation, and an entrepreneurial mindset, nirvanaHealth is the first to offer medical and pharmacy benefit management solutions that run on the same platform, made possible by our creation, Aria – the first robotic process automation cloud platform designed for healthcare.

Led by our chairperson John Sculley (former Apple CEO) and noted healthcare entrepreneur and founder of ikaSystems Ravi Ika, nirvanaHealth endeavors to sizably reduce the $900 billion in waste in healthcare administrative and medical costs. We are seeking A-players to join our team – folks who embrace the grind and hustle of a growing company, are collaborative and innovate, are life-long learners and growers, and have an entrepreneurial and positive mindset.

Job Summary:

The individual will analyze and understand the existing platform functionality and apply this understanding extensively through new client onboarding activities. They will identify enhancements of key features and functionality of the platform across different lines of business—Commercial, Medicare, Medicaid, and Exchange. The Business intelligence Analyst will deliver model and solution artifacts (e.g. operational code to support system decision/workflow and technical documentation) while operating autonomously to meet release schedules.

This position will play a critical role within a cross-functional team, delivering powerful solutions that inform network strategy and design, improve network performance and provider engagement, develop new provider offerings, and enhance consumer experience. The Business Intelligence Analyst will help solve problems, drive impact, and deliver key insights to RxAdvance clients by leveraging innovations in data science and machine learning.

Job Responsibilities:

• Analyze and understand existing platform functionality and apply this understanding for client onboarding activities.
• Use knowledge of algorithms and predictive models to investigate issues, detect patterns, and recommend solutions that are clear and impactful.
• Analytics and Reporting projects – current and new (cost and quality programs, member segmentation, risk assessment, risk prediction).
• Build dashboards for preempting risk and for anomaly detection using the Tableau and ELK (Elastic Search Logstash Kibana) stack.
• Perform analyses of structured and unstructured data to solve multiple and/or complex business problems utilizing advanced statistical techniques and mathematical analyses to transform client data into tangible business values. Communicate outcomes and collaborate on product development.
• Assist with developing models to conduct detailed analyses of pharmacy data, including pharmacy claims, Drug pricing and eligibility data.
• Monitor and review Medicaid, Medicare, and Exchange polices to ensure that the platform is compliant; If gaps are identified, work with technical and clinical teams to translate the state or federal regulations into configurable solutions
• Understand technical and system terminology to coordinate development and programming of claims adjudication engine, Focusing on group hierarchy, eligibility, pharmacy claims transaction, drug pricing, etc.
• Develop test cases, build validation scripts, test plans with Quality Assurance team as part of the client onboarding process.
• Develop baseline and moderate SQL queries in order to gather data, research and identify trends, discrepancies and solutions.
• Understand RDBMS such as Oracle to develop SQL database queries and conduct data analysis to validate existing platform functionalities and new developments.
• Responsible for conducting advanced analytics and collaborate with the technology team for various automation projects to develop and deliver solution-oriented products that drive innovation in our business.

Qualifications:

Education and/or Training:

• Bachelor’s Degree Required
• Master’s Degree in statistics, computer engineering, or any technology related field preferred

Professional Experience:

• 3 – 4 years’ minimum experience in data analytics/technical analysis using SQL and Tableau

Specialized Skills:

• Demonstrates strong ability to communicate technical concepts and implications
• Demonstrated competencies such as teamwork, creative problem solving, and flexibility
• A strong curiosity to continuously learn data science techniques and tools
• Ability to work within a climate of ambiguity
• Strong personal organizational skills
• Strong understanding of the PBM Industry and prior experience in Pharma or other healthcare settings is preferred
• Strong business and functional analytical thinking required
• Data Analysis skills; ability to navigate, and interpret data is a must

Technical Skills:

• Experience with Python/R, SQL or PL/SQL, Tableau/Kibana
• Experience and ability to write SQL queries against Relational Database systems is preferred
• Proficiency in mathematics and statistical analysis
• Good understanding of software systems and architectures
• Strong PC skills; MS Word, Excel, Access, and Power Point.

Additional Considerations:

• Applicants must be able to pass a background investigation as all offers are pending a successful completion of background check per the company policy