Senior Pharmacy Operations Analyst

Description:

Senior Pharmacy Operations Analyst – Medicare

Job type – 12 months contract with possible extension

Position Overview

We are seeking a highly analytical and compliance-driven Senior Pharmacy Operations Analyst to support critical Medicare initiatives within the pharmacy business. This role is instrumental in ensuring regulatory alignment, accurate member communications, and operational responsiveness across Medicare pharmacy programs.

The ideal candidate brings hands-on Medicare pharmacy experience, strong reporting acumen, and the ability to manage high-volume member materials under strict regulatory timelines.

Key Responsibilities
 

• Prepare, review, and distribute member materials including ANOC (Annual Notice of Change), EOC (Evidence of Coverage), and other required communications.
• Ensure adherence to CMS guidelines, government approvals, and submission deadlines.
• Review and edit Word and PDF documents to ensure governance, formatting, and compliance accuracy.
• Support Medicare pharmacy claims processes and reporting requirements.
• Perform detailed data entry related to member materials, pharmacy claims, and compliance documentation.
• Collaborate cross-functionally to maintain project timelines and regulatory readiness.
   

Required Qualifications
 

• Bachelor’s degree required (Advanced degree preferred). In lieu of degree, 5+ years of relevant Medicare/pharmacy experience will be considered.
• 3–5 years of experience in Medicare, pharmacy benefit management, or related healthcare operations.
• Strong working knowledge of Medicare pharmacy claims and compliance frameworks.
• Experience with regulatory reporting requirements.
• High level of accuracy in data entry and documentation management.
   

Preferred Qualifications
 

• Experience with member pharmacy benefits.
• Direct experience preparing or managing ANOC/EOC materials.
• Exposure to CMS submission processes and audit readiness standards.