Reporting to the Executive Director of Strategy and Real-World Evidence (RWE), supports the development and execution of a real-world evidence platform to drive data-driven insights on drug efficacy and member outcomes, as well as to inform ongoing contract negotiations with manufacturers. This position will work closely with internal stakeholders and external vendor(s) to ensure the operational success of critical analytic and reporting functions of the RWE platform, as well as drive and support ongoing strategy development, opportunity identification, and enhancements for the platform to meet the evolving needs of the Blue Specialty Rx Solutions organization on behalf of BCBS Plans.
- Develop detailed requirements that will inform the RWE platform build.
- Work collaboratively with internal stakeholders and external vendor(s), serving as the day-to-day business lead throughout and post- platform development.
- Own and drive analytics and reporting to support critical business operations of the organization, as well as ongoing strategic initiative needs (rebate administration, analytics to support business and policy decisions when engaging with manufacturers for pipeline therapies, other ad-hoc analytics as needed).
- Engage cross-functionally over time to explore and deploy analytic approaches in generating novel RWE insights that support strategy formation and negotiations with pharmaceutical manufacturers to develop innovative, market-leading outcomes-based arrangements for CGT and pipeline therapies.
Responsibilities include but are not limited to:
- Serve as the RWE Platform business lead, delivering the following: Supporting successful development & launch of the platform. Ongoing management of the platform, working internally and with external vendor(s) to regularly identify and address business and clinical needs supporting member outcomes tracking, medical policy. development, manufacturer negotiations, operational reporting, etc. Identification, prioritization, and execution of platform enhancements in support of the organization's strategic roadmap; work closely with leadership to outline and secure resources as needed. Vendor management - serve as business lead on behalf of the organization to identify and address platform defects, as well as align on and oversee implementation of ongoing enhancements.
- Lead RWE Platform analytic initiatives, such as: Outcomes analytics and reporting for validation, as well as anticipation of, clinical endpoints. Leveraging the above to inform medical policy decisions, as well as contract (re)negotiations with manufacturers. Working with external vendor(s), oversee reports generated regularly as part of rebate administration process. Working with external vendor(s), ongoing exploration of novel approaches to and development of generation of RWE insights, aligned to the organization's therapy roadmap. Leverage analytics to inform regular internal discussions, such as quarterly projections as an input into financial planning, development of innovative approaches to value-based payment and outcomes models, etc.
- Provide ad-hoc support as the need arises, including but not limited to: Rebate administration - invoicing for manufacturers, as well as managing collection, cleaning, and analysis of Plan data received for validation of rebate eligibility. Managing novel pilots for strategic initiatives, working closely with Plans and vendor(s) to identify learnings, as well as determine potential scalability.
Required Basic Qualifications:
- Bachelor's Degree in related discipline or equivalent work experience within a similar environment
- 3 years experience with:
- Applied analytic experience using health care data in a complex environment requiring multiple deliverables and timelines.
- Demonstrated mastery of data manipulation skills using SQL, Access, Excel
- Data collection, analysis, modeling, and reporting for diverse sets of stakeholders/clients leveraging health care data
- Leveraging broadly used statistical analytic software, including R and/or Python
- Familiarity with data visualization and graphics techniques using R, Python, and/or Tableau
- Demonstrated ability to manage divergent deliverables with overlapping timetables in a fast-paced business setting
- Demonstrates creative thinking and adaptability to manage increasing volume and complexity of workload and variety of users
- Demonstrated ability to successfully implement projects in a timely manner
Preferred Basic Qualifications:
- 2 years of experience working with medical claims, provider, and other clinical data
- 2 years of experience in developing and editing complex reports, to achieve technical accuracy, clarity of expression and consistency of presentation and style
Equal Opportunity Employer
Blue Cross Blue Shield Association is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, national origin, age, gender identity, disability, veteran status, genetic information or any other legally protected characteristics.