Medication Use & Management Analyst

The Analyst for Medication Use and Management is responsible for the collection and analytics for clinical medication and medication related data from our EPIC EMR MedWise PBM medical claims and finance data to support interventions related to participant medication use optimization and regulatory compliance. Works closely with the Clinical Analytics team on related initiatives.

Essential Functions and Work Responsibilities

Functional Category: Medication Use

Estimated Percent of time Spent 85%

• Analyzes pharmacy medication claims data for potential fraud waste and abuse including overcharges over dispensing and wasteful utilization
• Synthesizes several data sources to report clinical quality and performance metrics in an accurate and timely manner to appropriate organizational senior leadership. Data sources include but are not limited to: EPIC EMR MedWise PBM medical claims and finance data.
• Develops and executes data analyses to support clinical quality improvement care management utilization management in collaboration with clinical leadership.
• Supports Clinical Leaderships CVI and medication use initiatives with data accumulation consolidation for performance tracking intervention targeting and improvement
• Performs concurrent review and retrospective in-depth analysis of patient records and medication claims data for purposes of identifying quality improvement opportunities.
• Develops maintains and improves a key performance indicators (KPI) data dashboard for use by senior management to track and trend organization-wide performance.

Functional Category: Healthcare Coordination

Estimated Percent of time Spent 15%

• Generates data analyses and reports for presentation to select audiences; including company senior leadership clinical and quality staff. Possesses strong presentation skills; presenting results orally in writing and visually for review by both subject matter experts as well as lay people.
• Serves as the organization-wide content expert across all lines of business for measurement and analysis methods. Imparts knowledge of methods for data collection implications for research and opportunities for data-driven improvements to senior leaders and quality staff. Continually expands and updates this knowledge.
• Interacts frequently with clinical leadership and quality personnel including Risk Management Compliance Clinical staff etc. Facilitates discussions with these stakeholders of existing data reports and analyses while assessing unmet needs and potential enhancements. Advises on trends and helps coordinate project teams to improve processes.
• Additional collaborations with Information Technology (IT) Data Analytics and Clinical Application departments for reporting development.

Travel Requirements

Travel

• Travel may be required
• Overnight travel may include local or out of state

Relocation

Qualifications

To perform this job successfully an individual must be able to perform each essential duty satisfactorily. Requirements listed below are representative of the knowledge skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions

• Bachelors degree in research statistics health administration or a related field from an accredited college or university or equivalent work experience.
• Minimum of 3 years of experience with data analysis. Experience with a health plan or PBM is preferred.
• Minimum of 3 years of experience with generating and ensuring accurate and easily understood data analyses and presenting results orally in written form or graphical format for review by both subject matter experts as well as lay people.
• Working knowledge of healthcare industry medication quality measures clinical performance and financials measures.
• Experience with obtaining and manipulating health care data such as: medication claims clinical values etc.

PREFERRED

Work Experience and Qualifications

• Working experience with EPIC slicer/dicer and Clarity data program.
• Mastery of desktop applications including MS Office (Teams Word Excel and PowerPoint).
• Advanced skills using Tableau Excel SQL and other databases. Skills required include but are not limited to; construction and use of pivot tables use of advanced formulas and use of VBA and Macros.
• Able to establish and maintain cooperative and positive working relationships.
• Organized detail-oriented diplomatic proactive self-motivated dependable and driven by excellence.
• Even-tempered and able to balance multiple tasks in accordance with changing deadlines and priorities in a fast-paced environment.
• Ability to work sensitively and effectively with individuals of diverse ethnic and cultural backgrounds.

InnovAge is dedicated to empowering seniors to live independently allowing them to age in their own homes and communities safely. InnovAge offers an alternative to nursing homes through its Program of All-inclusive Care for the Elderly (PACE) which provides enrolled seniors with customized healthcare and social support at PACE Adult Day Health Centers. These centers are staffed by medical professionals who are committed to creating personalized care plans for each participant. At InnovAge our team members are our greatest asset and have a significant impact on the lives of our participants every day. When you join InnovAge youll work alongside talented respectful and passionate colleagues within a patient-centered care model.

InnovAge is committed to equal opportunity and affirmative action and we strive to create a diverse and inclusive workplace. We consider all qualified candidates for employment without discrimination based on race color religion sex sexual orientation gender identity/expression national origin disability protected veteran status pregnancy or any other protected status. Salaries are determined by various factors such as qualifications experience and location and do not include potential bonuses or benefits. Our extensive benefits package includes medical/dental/vision insurance short and long-term disability life insurance and AD&D supplemental life insurance flexible spending accounts 401(k) savings paid time off and company-paid holidays.

Applicants are considered until the position is filled.

Compensation Disclaimer

The pay may vary depending on job related factors such as work location experience knowledge skills education certifications training and internal equity. InnovAge offers a comprehensive benefits package which includes medical dental vision 401(k) plan with company match short and long-term disability life insurance supplemental life insurance ADD flexible spending account paid time off and company paid holidays.

Attention Florida Applicants
This position requires a background screening through the Florida Care Provider Background Screening Clearinghouse.
For more information please visit the Clearinghouse Education and Awareness website:

Agency Disclaimer

InnovAge will not accept unsolicited resumes from search firms for this employment opportunity. Regardless of past practices all candidates/resumes submitted by search firms to InnovAge by any means without a valid written search agreement in place for that position will be deemed the property of InnovAge and no fee will be paid in the event such candidate is hired by InnovAge.

Fraud Disclaimer

InnovAge is committed to maintaining a safe transparent and respectful hiring process for all candidates.

Please be aware that all legitimate email communication regarding InnovAge job opportunities will come exclusively from an email address ending in @.

At no point in our hiring process will InnovAge:

• Request payment from candidates for equipment background checks onboarding training or any other employmentrelated purpose
• Ask for financial information (such as bank account details) before a formal offer and onboarding process is completed through our official systems

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If you believe you have been contacted by someone misrepresenting InnovAge please report the activity to or apply directly through our official career site to ensure the opportunity is legitimate.

Your trust matters to us and we appreciate your interest in joining InnovAge.