Note: The job is a remote job and is open to candidates in USA. Landid LLC is partnering with a national leader in home-delivered diabetic medical products and chronic care solutions. The Manager, Pricing & Reimbursement Analytics will analyze pharmacy reimbursement, PBM contracts, claims, utilization, and patient economics to guide pricing, contracting, and patient-service decisions. This role will also build financial models, deliver recommendations to senior leaders, and improve pricing tools and reporting through automation and AI.
Responsibilities
- Analyze PBM contracts, Medicare Part D reimbursement, claims, utilization, and patient economics to improve revenue, gross profit, and patient access
- Build financial models evaluating reimbursement, cost, margin, and forecasted opportunity, including whether patients are best served through the pharmacy benefit or Medicare Part B/medical benefit
- Recommend when to serve a patient, seek a rate increase, renegotiate terms, or take another approach to improve financial performance
- Turn complex analysis into clear recommendations and present them persuasively to leaders across Finance, Operations, Sales, and Revenue Cycle
- Improve pricing tools and reporting through automation and AI
Skills
- Five or more years of experience in pharmacy reimbursement, PBM contracting, pricing analytics, managed care finance, pharmacy economics, or a closely related area
- Strong understanding of PBM contracts, Medicare Part D reimbursement, claims economics, reimbursement methodologies, and the financial factors affecting pharmacy profitability
- Demonstrated ability to build and interpret financial models evaluating reimbursement, cost, margin, utilization, and forecasted business opportunities
- Experience translating complex data and contract terms into clear business recommendations that improve revenue, profitability, and patient access
- Strong communication and presentation skills, including the ability to influence senior leaders and explain complex findings to senior level stakeholders
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