Job Description

We are seeking a detail-oriented, proactive, and client-facing individual to join our team. As a Payer Strategy Analyst on our Patient Services team, this position offers a dynamic and impactful role in shaping the access and reimbursement strategies of our clients, with a clear focus on the ever-evolving payer landscape. The successful candidate will play a crucial part in ensuring that drug manufacturers are equipped with the necessary insights and strategies to maintain access to their therapies in an increasingly complex insurance environment.

This role will be pivotal in providing comprehensive research and insights related to payer policies, drug formulary lists, and insurance payer changes. The ideal candidate will work closely with internal market access teams and external clients (drug manufacturers) to ensure seamless transitions and communication when payer policy guidelines and drug formulary statuses are modified or updated.

A typical day in the life of a Payer Strategy Analyst will include the following:

The responsibilities include, but are not limited to the following:

• Payer Policy Guideline Research:
• Conduct in-depth research on the latest payer policies, including but not limited to medical and pharmacy guidelines.
• Review and interpret payer policy changes and analyze their impact on drug access, coverage, and reimbursement.
• Stay current with insurance company guidelines and formulary updates to ensure accurate and timely information.
• Track payer-specific requirements, conditions, and restrictions that may influence drug formulary decisions.
• Drug Formulary List Research:
• Research and compile comprehensive data on the status of drugs on payer formularies, including preferred status, tier placement, and clinical criteria for coverage.
• Identify any changes in drug formulary listings and analyze the impact of such changes on market access and patient treatment options.
• Collaborate with market access teams to ensure that drug formulary data is accurate and up-to-date.
• Client-Facing Responsibilities:
• Serve as the primary point of contact for drug manufacturers regarding payer policy and formulary research.
• Provide expert guidance and recommendations to clients about payer and formulary changes and their potential business impacts.
• Collaborate with the client to strategize responses to changes in payer policies and formularies.
• Prepare reports, summaries, and presentations for clients to communicate key insights and strategic recommendations.
• Market Access Team Collaboration:
• Work closely with internal market access teams to align strategies and understand their objectives related to payer policies and formulary placements.
• Provide actionable insights and recommendations for overcoming barriers to drug access, reimbursement, and formulary placement.
• Assist in the development of materials and strategies to address payer-related challenges, including payer policy changes, formularies, and coverage determinations.
• Payer Change Management:
• Monitor payer landscape for changes in drug coverage, formulary status, and medical policies.
• Facilitate coordination between the drug manufacturer’s team and payer organizations when formulary changes or payer policy adjustments occur.
• Provide real-time updates and collaborate with stakeholders to manage the impact of payer policy changes on drug access and reimbursement.

• Cross-Functional Collaboration:
• Liaise with internal departments such as legal, regulatory, and marketing teams to ensure comprehensive support during policy changes.
• Assist in the preparation of dossiers, submissions, and other materials for payer negotiations.
• Data Management and Reporting:
• Maintain comprehensive databases tracking payer policies, formulary statuses, and client interactions.
• Regularly update internal stakeholders on key payer policy changes and formulary decisions.
• Analyze and present research findings in a clear, concise manner to facilitate decision-making.
• Continuous Learning and Professional Development:
• Stay current with trends, regulations, and changes in healthcare payer systems, insurance, and pharmaceutical markets.
• Attend relevant training sessions, webinars, and conferences to enhance industry knowledge and skills.

This job might be for you if (must have requirements of the role):

Successful candidates possess the following personal attributes:

• Strong analytical and research skills, with the ability to synthesize complex payer information and present actionable insights.
• Excellent verbal and written communication skills to effectively interact with clients and internal stakeholders.
• Ability to collaborate effectively across various functions and manage multiple priorities in a fast-paced environment.
• Strong proficiency in Microsoft Office Suite (Excel, PowerPoint, Word) and familiarity with data management tools and systems.
• Strong attention to detail and ability to work independently.
• Ability to build and maintain strong relationships with both clients and internal teams.
• Flexibility and adaptability to meet client needs in a changing healthcare landscape.
• Understanding of healthcare payer systems, insurance structures, and drug formulary processes.

Requirements:

The ideal team member should possess the following:

• Bachelor’s degree strongly preferred in Pharmacy, Life Sciences, Healthcare Administration, Business, or a related field. Advanced degrees (e.g., PharmD, MBA, MPH) are a plus.
• Minimum of 3-5 years of experience in medical affairs, pharmacy benefits management, or market access, with a focus on payer policy and formulary research.
• Proven track record of working directly with clients, particularly in the pharmaceutical or healthcare industry.
• Experience in navigating and interpreting payer policies, formularies, and healthcare regulations.
• Familiarity with drug reimbursement processes, payer negotiations, and formulary placement strategies.
• Bi-lingual in English and Spanish or Chinese/Mandarin is a plus
• We are located in Jeffersonville, IN. PharmaCord does reimburse for tolls if applicable, at the frequent user rate. This rate is applied after 40 trips per month (valued at $678.60 per year)
• Hybrid or Remote work options may be available for this role.

Physical Demands & Work Environment:

• While performing the duties of this job, the employee is regularly required to talk or hear. The employee is frequently required to sit for long periods of time, use hands to type, handle or feel; and reach with hands and arms. Must be able to type 35 WPM with 97% accuracy.
• Although very minimal, flexibility to travel as needed is preferred.
• This is an office-based position, the ability to sit for extended periods of time is necessary
• This job operates in a professional office environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, etc.
• Due to investment in program specific training, candidates are expected to maintain role for a minimum of 6 months, or within a client-facing role, prior to being considered eligible for lateral or promotion level move. PharmaCord is committed to creating a strong company culture that values collaboration, employee development, and promotion from within. Exceptions will be reviewed on a case-by-case basis to assess business need and service impact.

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