Senior Financial Analyst

Now Hiring: Senior Financial Analyst - PBM Financial Modeling & Analysis SME

Location: Remote (USA)

Contract-to-Hire | Opportunity to Transition to Permanent Role

Employment Type: Full-Time

Industry: Pharmacy Benefit Management (PBM), Financial Analytics

About the Role:

We are looking for a Senior Financial Analyst - Pharmacy SME to lead strategic financial modeling, forecasting, and rebate analysis for pharmacy programs. This role works at the upstream level, translating rebate and discount contracts into actionable financial insights using enrollment, utilization, and trend data.

You'll partner with product, actuarial, and executive teams to drive pharmacy financial planning, pricing strategy, and economic impact assessments, enabling smarter decisions across the organization.

Key Responsibilities:

• Translate rebate, discount, and fee agreements into financial forecasts to evaluate overall contract value.
• Analyze pharmacy claims data, utilization trends, and pricing shifts to inform benefit modeling and financial planning.
• Support formulary decision-making and drug pricing strategies through economic impact modeling.
• Build predictive models to assess pharmacy program performance and communicate insights to senior leadership.
• Maintain financial oversight of rebate payments, PBM fees, Medicaid/Medicare Part D projections, and drug cost containment strategies.
• Contribute to enterprise forecasting and budgeting for pharmacy benefits.
• Partner with actuarial, finance, and PBM strategy teams to ensure financial sustainability of pharmacy programs.

Must-Have Skills:

• 5+ years in healthcare finance, accounting, actuarial, or PBM financial analytics
• Deep expertise in pharmacy rebates, discount modeling, and benefit forecasting
• Hands-on experience with financial modeling, pharmacy claims data, and drug pricing economics
• Strong knowledge of Medicare Part D, Medicaid pharmacy regulations, and formulary impact modeling
• Proficiency in SQL, Excel, and financial forecasting tools
• Exceptional communication skills and the ability to translate complex data into executive-level insights

Key Focus Areas & Keywords:

• PBM financial modeling (e.g., OptumRx, CVS Caremark, Express Scripts)
• Pharmacy rebates / network discounts / contract fee forecasting
• Utilization trend analysis and cost modeling
• Formulary economics and benefit design input
• Drug cost containment and pricing impact analysis
• Actuarial collaboration and enterprise planning
• Pharmacy financial planning tools and dashboards

Qualifications:

• Bachelor s degree in Finance, Accounting, Economics, or related field
• (In lieu of a degree, 4 additional years of relevant experience may be considered)
• CPA or MBA preferred
• Prior experience in managed care, health insurance, or PBM finance highly desirable