Senior Analyst, Analytics - Regulatory Reporting

Position Summary: 

We are seeking a highly technical and detail-oriented Senior Analyst to support the development, maintenance, and execution of pharmacy benefit management regulatory reporting. This role will serve as a technical delivery partner to Government Programs and other internal stakeholders responsible for regulatory interpretation, compliance review, and report submission. 

The Senior Analyst will translate documented regulatory and business requirements into accurate, repeatable, and well-governed reporting solutions. The ideal candidate will have strong SQL skills, experience working with pharmacy claims data, and an understanding of PBM or government program operations. This individual will independently manage recurring reporting deliverables, implement approved reporting changes, and help establish scalable and standardized reporting processes.

Key Responsibilities:  

• CMS Regulatory Reporting 
  • Develop, maintain, update, and execute CMS-required regulatory reporting related to pharmacy benefit management. 
  • Translate documented CMS requirements and approved reporting methodologies into reliable technical solutions. 
  • Use the approved reporting methodology consistently across clients. 
  • Complete technical checks to confirm reporting processes execute as intended before Government programs leads validation and compliance review. 

• Reporting Standards and Improvement 
  • Maintain reporting code, technical documentation, assumptions, dependencies, and change history using  established standards. 
  • Implement approved changes to CMS-required reports while preserving consistent methodology and governance. 
  • Standardize and automate recurring reporting processes to reduce manual effort and improve scalability. 

• Cross-Functional and Collaboration 
  • Partner with Government Programs to clarify requirements and translate documented CMS guidance into actionable technical deliverables. 
  • Collaborate with subject matter experts to understand source data, operational processes, and technical dependencies. 
  • Communicate progress, risks, dependencies, and the impact of requirement or priority changes. 
• Delivery and Continuity 
  • Independently manage reporting deliverables from requirements review through development, technical testing, stakeholder review, and recurring execution. 
  • Manage scope, timelines, and dependencies, escalating risks early with recommended actions. 
  • Maintain reporting documentation and reusable code templates to support continuity, knowledge transfer, and efficient report generation. 

Qualifications & Experience:  

• 4–6 years of experience in data analytics, business intelligence, healthcare analytics, or a related field, including 2–3 years of direct experience analyzing medical claims data. 
• Four or more years of healthcare data or analytics experience.
• Four or more years of proven experience supporting government programs. 
• Experience with Medicare Part D, Medicaid, Marketplace, or state regulatory reporting and related pharmacy data or processes.
• Experience working with pharmacy claims data and PBM-related business processes. 
• Advanced SQL skills and experience working with large, complex datasets. 
• Experience developing, maintaining, or executing recurring analytical or regulatory reports. 
• Experience with Snowflake, Python, Jupyter notebooks, or GitHub. 
• Ability to translate documented requirements into accurate and maintainable technical solutions. 
• Strong problem-solving, documentation, and cross-functional communication skills. 
• Ability to independently manage multiple complex deliverables and shifting priorities. 
• Bachelor's degree in Computer Science, Statistics, Economics, Healthcare Administration, Business, or a related field, or equivalent relevant experience. 

Preferred Qualifications: 

• Experience supporting CMS-required PBM regulatory reporting. 
• Knowledge of prior authorization, grievances, coverage determinations, encounter data, or related government program operations. 
• Experience standardizing code, automating recurring reporting, or supporting production reporting processes. 
• Experience with Tableau or a comparable business intelligence and data-visualization tool