About the job
The Opportunity: As a Healthcare Data Analyst, you will play a critical role in reading, understanding, and assessing the medical and pharmacy policies of US Health Insurance companies (also called payers) based on the criteria defined by the subject matter experts. This role requires excellent communication skills, as the Healthcare Data Analyst, will be responsible for distilling complex policy information into understandable terms and engaging effectively with stakeholders to ensure compliance and alignment with our objectives. • Conduct detailed reviews of medical and pharmacy policies from various US Health Insurance Companies across Commercial, Medicare, and Medicaid plans and formulary validation • Assess these policies in the context of our guidelines & criteria such as payer coverage criteria, formulary status, prior authorization (PA), step therapy (ST), and other utilization management (UM) restrictions as established by the business leads • Utilize analytics tools and methodologies to generate insights, providing recommendations for business improvements • Act as a thought partner, collaborating with internal teams to strategize and optimize business processes & rules based on analytical findings • Clearly communicate findings, implications, and recommendations to internal teams and external partners; ensuring complex information is easily interpretable • Develop and maintain documentation related to policy assessments and compliance activities • Contribute to the internal initiatives, which includes adhoc projects and employee engagement programs Who you are: • You hold a bachelor's degree in Life Sciences (Pharmacology, Dentistry, or a related field) and 2 to 5 years of experience in Pharma/Healthcare (pharmacovigilance, insurance, health IT) • Certification in SQL, Power BI, or similar technical skills is preferred • Prior experience in the corporate healthcare industry is required • Experience in healthcare policy, insurance, compliance, or related areas with solid knowledge of US healthcare regulations is highly desirable • Familiarity with secondary data sources such as FDA databases, Redbook, and clinical labels is preferred • Strong analytical mindset with keen attention to detail, able to communicate complex information clearly and concisely • Excellent interpersonal and communication skills with proven stakeholder engagement skills; effective team member in a cross functional and dynamic environment • Proficient in Microsoft 365 and Google Suite Workspace • Technical expertise in Excel required; working knowledge of SQL and Python or similar programming language is good to have • Demonstrated ability to work independently as well as collaboratively in a dynamic environment, managing multiple priorities effectively
Requirements
- Healthcare Policy
- SQL
- Power BI
- Analytical Skills
Qualifications
- Bachelor's degree in Life Sciences
Preferred Technologies
- Healthcare Policy
- SQL
- Power BI
- Analytical Skills
About the company
Roche has established the Global Analytics and Technology Center of Excellence (GATE) to drive analytics & technology driven solutions by partnering with Roche affiliates across the globe. Our efforts result in more than 26 million people treated with our medicines and over 30 billion tests conducted using our Diagnostics products.
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