Sr. Analyst, Government Pricing

Overview

A growing healthcare organization is seeking a Senior Analyst, Government Pricing to provide advanced analytical support for Medicaid Fee-for-Service (FFS) pharmacy programs. This role focuses on Medicaid Maximum Allowable Cost (MAC) pricing, 340B program impacts, and cost analysis driven by Statements of Work (SOW). The position involves evaluating pricing methodologies, utilization trends, and regulatory impacts to support forecasting, program strategy, and decision-making for clients and vendors.

Responsibilities

• Develop and maintain Medicaid FFS pharmacy pricing and modeling aligned with organizational strategies and products.
• Oversee analytical work related to SOW requirements, including Medicaid MAC pricing analysis and 340B program compliance.
• Create and enhance cost analysis and predictive trending models segmented by SOW, pricing methodology, or program initiative.
• Manage capture, ingestion, and maintenance of external pricing files such as NADAC, state MAC files, and other benchmarks.
• Perform data quality checks, validate pricing data, identify and correct anomalies, and conduct market research to ensure pricing accuracy.
• Establish and maintain a Tier 2 inquiry process for MAC-related issues, including tracking inquiries, documenting resolutions, assessing impacts, and supporting trend analysis.
• Collaborate with leadership and internal teams to interpret Medicaid regulations, state-specific requirements, and program initiatives for pricing strategies and reporting.
• Work with internal stakeholders (Client Services, Contracting, Operations, Compliance) to evaluate financial and contractual impacts of Medicaid pricing decisions.
• Build collaborative relationships with external stakeholders and vendors to support pricing accuracy and program execution.
• Provide ad hoc analysis, forecasting, and scenario modeling related to Medicaid FFS pricing and regulatory developments.
• Assist leadership with new Medicaid program initiatives, pricing methodology enhancements, and analytical capability expansion.
• Contribute to client- or state-facing materials and presentations explaining pricing methodologies, cost drivers, and program impacts.
• Report activities and opportunities to leadership periodically.
• Perform other duties as assigned.

Qualifications

• Bachelor’s degree in Finance, Economics, Healthcare Administration, Data Analytics, or related field, or equivalent work experience.
• Minimum 5 years of experience in pharmacy benefit management (PBM), Medicaid pharmacy programs, managed care, healthcare analytics, or pricing analysis.
• Experience supporting Medicaid fee-for-service drug pricing methodologies compliant with federal and state Medicaid requirements.
• Proven ability to prepare documentation, reporting, and analysis for internal reviews, regulatory inquiries, audits, and client requests.
• Familiarity with industry pricing and reference sources such as Medi Span multisource and product codes (e.g., MONY indicators), NADAC pricing files, and HRSA 340B ceiling price data.
• Experience conducting pricing impact analyses and maintaining financial models to support Medicaid SOWs, amendments, and renewals.
• Commitment to compliance program objectives.
• Strong interpersonal skills with the ability to interact cooperatively and respectfully with colleagues.

Compensation & Benefits

• Salary range: $69,627 to $83,888 per year
• STAR Bonus: Up to 5% (at-risk, salaried non-management except pharmacists)
• Health, Dental, and Vision insurance
• 20 days paid time off
• 4 weeks paid parental leave
• 9 paid holidays
• 401(k) company match up to 5% with no vesting requirement
• Adoption Assistance Program
• Flexible Spending Account
• Educational Assistance Plan and Professional Membership assistance
• Referral Bonus Program up to $750

Work Schedule

• Monday through Friday, 8:00 AM to 5:00 PM

Location

• Remote within the United States
• Note: Remote work is not available to residents of Alaska, Hawaii, Maine, Mississippi, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, West Virginia, and Wyoming.