Medication Use & Management Analyst

Essential Functions and Work Responsibilities: Functional Category: Medication UseEstimated 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 Leadership's 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.

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 functionsREQUIREDBachelor's 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.

PREFERREDWork 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.

Benefits: 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, you'll 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. Posted Pay Range$77,400 - $96,800

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: https://info.flclearinghouse.comAgency DisclaimerInnovAge 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 DisclaimerInnovAge 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 @innovage.com. At no point in our hiring process will InnovAge: Request payment from candidates for equipment, background checks, onboarding, training, or any other employment-related purpose Ask for financial information (such as bank account details) before a formal offer and onboarding process is completed through our official systems If you receive a message claiming to represent InnovAge that does not align with the above, it may be fraudulent. We encourage you to exercise caution and refrain from engaging or sharing personal information. If you believe you have been contacted by someone misrepresenting InnovAge, please report the activity to HRAnswers@innovage.com 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.