Healthcare Data Systems SME I

Location: Remote

Employment type: Part time

Company

hirify.global provides healthcare management consulting and supports commercial, state, and federal health and human service programs through medical claims, records, data, audit, compliance, policy, and clinical expertise.

What you will do

• Analyze raw and preliminary trend data to identify variances, outliers, percentile-ranked groups, quality-improvement opportunities, and areas for focused investigation.
• Provide analytical and technical support for pharmacy and healthcare data interpretation, cost-trend analysis, and methodology development.
• Design, develop, and maintain repeatable analytical processes, data workflows, and systems that support accuracy, timeliness, responsiveness, and compliance.
• Analyze data, draw conclusions, and prepare reports, tables, graphs, recommendations, and leadership guidance.
• Evaluate, modernize, and operationalize pharmacy-related data systems using knowledge of benefit structures, pricing models, clinical data, and operational data flows.
• Collaborate with cross-functional SMEs and government teams on program alignment, staffing and transition planning, and client Business Associate Agreement requirements.

Requirements

• Bachelor’s degree in data science, public health, pharmacy, health informatics, statistics, computer science, or a related field.
• At least five years working with pharmacy, healthcare, or claims data systems, including analytics, data engineering, data quality management, or related functions.
• At least five years supporting government pharmacy or healthcare benefit administration, such as DoD, VA, CMS, or similar programs.
• Deep understanding of pharmacy claims data, including NCPDP, NDC, formulary attributes, and network data.
• Experience with federal data environments, large-scale datasets, and enterprise data warehouses.
• Proficiency in statistical analysis, modeling, or analytical tools such as SQL, SAS, R, Python, or Power BI; fluency in SAS or other statistical programming software and MS Office.
• Experience in at least four areas: pharmacy benefit management data operations, pricing or financial modeling, clinical or formulary analytics, benefit design modeling, data system architecture, or data governance.
• Familiarity with statistical and epidemiological methodologies, automation techniques for analytical tasks, healthcare systems, healthcare databases, and coding systems.
• Ability to work independently and in teams, handle highly sensitive information confidentially, interpret technical and governmental materials, prepare reports and procedures, present findings, and apply advanced mathematical and statistical concepts.

Nice to have

• Advanced degree such as MS, MPH, PharmD, or MBA with an analytics emphasis.
• Experience supporting DoD programs.
• Working knowledge of Medicare and Medicaid.

Culture & Benefits

• Part-time remote position.
• Employee-centric environment focused on employee well-being and value.
• Work supports healthcare and human service programs and philanthropy for nonprofit organizations.
• Equal opportunity and affirmative action employer with a commitment to a diverse workforce and veteran-friendly employment.