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Location: Remote (For Non-Local) or Hybrid (Local to NYC area)
About Capital Rx
Capital Rx is a next generation pharmacy benefits manager, overseeing prescription benefit plans on behalf of employers, unions, and government entities. Determined to transform an outdated model, Capital Rx’s mission is to change the way prescription benefits are priced and administered in the US, unlocking enduring social change. Through our platform approach, Capital Rx delivers data-driven insights and actionable strategies that reduce costs, while improving patient outcomes. Our commitment to innovation, technology and service is the reason why Capital Rx is among the fastest-growing PBMs in the country.
Position Responsibilities
- Lead continued monitoring of pharmacy pricing to ensure contractual and reconciliation alignment
- Ensure pricing is accurately produced and maintained, including coordination with other business functions
- Drive timely resolution for potential network pricing variances identified
- Identify potential network pricing variances and drive timely resolution
- Analyze and review testing outputs to ensure claims are accurately pricing
- Collaborate with other business functions (clinical, underwriting, finance, network) to design, refine, and maintain internal pricing, modeling, and reporting SOPs
- Evaluate pharmacy performance and produce reconciliation analyses for book-of-business
- Perform financial analysis of current and prospective pharmacy partnerships
- Support analysis and development of pricing models with an eye for process improvement
- Support general business needs, as required
Required Qualifications
- Undergraduate bachelor’s degree, with record of strong academic performance in Accounting, Finance, Actuarial Science, Statistics, Economics, Mathematics, or Business Administration
- 3+ years of proven experience in financial analysis, actuarial services, accounting, pricing & underwriting, network pricing, or pricing operations
- The ideal candidate will understand pharmacy pricing dynamics and have experience evaluating financial performance of pharmacy plans with an eye for accuracy
- Experience working with structured and unstructured data
- Highly analytical; demonstratable knowledge of SQL, Excel, or other data visualization tools (Python or R experience preferred though not required)
- Track record of leading cross-functional initiatives, driving high performance, meeting deadlines, and executing on deliverables
- Strong attention to detail with an intellectual and professional curiosity
- Ability to balance multiple complex projects simultaneously
- Exceptional written and verbal communication skills
- Extremely flexible, highly organized, and able to shift priorities easily
Base Salary: $80,000 – $110,000
This range represents the low and high end of the anticipated base salary range for the NY – based position. The actual base salary will depend on several factors such as: experience, knowledge, and skills, and if the location of the job changes.
Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
