Senior Analyst, Analytics - Client Reporting

requirements (e.g., CMS, NCQA, URAC), and industry trends to effectively position our solutions. Serve as a liaison between the field and internal product/clinical teams to ensure offerings remain competitive and relevant. Support implementation handoffs to ensure smooth onboarding of new clients. Provide market feedback to inform future product development and innovation. Support general business needs and operations, as required. All employees are responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance. Minimum

Qualifications: Education: Bachelor’s degree in Business, Healthcare Administration, or related field (MBA preferred) 7 years of total work experience. 5+ years of applicable experience in a health plan or PBM, or healthcare sales and/or completion of a PGY1 Clinical Pharmacy Residency Program, Managed Care Residency or Fellowship with additional 2+ years of applicable experience Exceptional negotiation, presentation, and communication skills with the ability to articulate clinical value propositions to diverse audiences. Experience engaging or partnering with pharmacy consultant firms Working knowledge of pharmacy benefit management, Medicare Part D, and commercial pharmacy

benefits Ability to analyze data and market trends to inform sales strategy and client recommendations. Proven track record of meeting or exceeding sales targets and successfully closing complex B2B deals. Maintain an active, unrestricted pharmacy license in the state of residence Ability to balance multiple complex projects simultaneously with minimal direction Ability to travel up to 50% Preferred

Qualifications: PharmD Experience working with HEDIS, Stars and PQA pharmacy quality measures Proficient in Microsoft Office Suite with emphasis on Microsoft Excel and PowerPoint Experience with Confluence, Jira, Tableau Highly detail-oriented and analytical Visa Sponsorship: Capital Rx does not provide sponsorship to any candidates. This includes, but is not limited to those that require H1-B, TN, OPT, etc. Candidates must have authorization to work in the US at the time of application and throughout employment. This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and

responsibilities as needed to best meet organizational goals. Utilization Management Pharmacist (temp-to-hire) Remote $125,000 - $130,000 USD Position Summary: The Utilization Management Pharmacist plays a vital role in promoting safe, effective, and appropriate medication use. This position is responsible for reviewing prior authorization requests, supporting clinical programs, and providing expert guidance to members, providers, and pharmacies.

The role combines clinical decision-making with a strong focus on service excellence in a fast-paced, collaborative environment. Position

Responsibilities: Review and make timely, evidence-based decisions on prior authorizations, appeals, and override requests using clinical guidelines and benefit criteria. Ensure compliance with federal, state, and internal regulations across Commercial, Exchange, Medicare, and Medicaid plans. Accurately document clinical decisions and maintain thorough records in accordance with regulatory and accreditation (URAC/NCQA) utilization review standards. Provide clear, empathetic support to members, prescribers, and pharmacies by responding to clinical inquiries via phone, demonstrating professionalism, active listening, and a patient-centered approach. Stay current with clinical prescribing guidelines, internal policies, and regulatory changes, and apply them to daily

responsibilities. Follow all internal procedures, job aids, and HIPAA guidelines to protect patient privacy and data security. Identify and report potential fraud, waste, and abuse. Support training and development of new and existing team members as needed. Assist leadership with special projects, process improvements, and operational initiatives Minimum

Qualifications: Minimum of 6 months to a year of prior authorization or utilization management experience Active, unrestricted, pharmacist license Bachelor’s or Doctor of Pharmacy degree Minimum of 2 years of pharmacy practice experience Experience in managed care or pharmacy benefit management (PBM) Strong communication, writing, and organizational skills Ability to manage multiple priorities in a high-volume, metric-driven environment Availability to work after hours, weekends, and holidays on a rotating schedule Preferred

Qualifications: Call center experience This position description is designed to be flexible, allowing management the opportunity to assign or reassign duties and

responsibilities as needed to best meet organizational goals. Manager, Client Experience Resolution & Optimization (CERO) Denver, Colorado, United States $110,400 - $138,000 USD Position Summary The Manager of Client Experience Resolution & Optimization (CERO) leads the intake, triage, and resolution process for client-impacting issues within Client Services. This role establishes governance for intake workflows, ensures issues are accurately validated and routed, and drives consistency in how Client Services manages and resolves operational challenges. The Manager partners across the organization to streamline processes, reduce manual work, and improve end-to-end client experience, while providing coaching for the CERO Analyst. Position

Responsibilities: Build and manage a standardized intake and routing process for Client Services issues. Govern issue of triage, prioritization, and cross-functional coordination. Serve as the primary point of contact for inquiries related to intake, validation, and routing. Develop and maintain SOPs, workflows, and documentation supporting Client Services operations. Establish and monitor high‑level performance indicators (e.g., intake volumes, turnaround times, quality measures) in partnership with internal analytics teams. Lead continuous improvement initiatives aimed at simplifying workflows and reducing recurring issues. Partner with functional teams to identify process gaps and support implementation of improvements. Coach, mentor, and support ongoing development of the CERO Analyst. Required

Qualifications: Bachelor’s degree is required 5+ years of experience in client services, operations, or workflow/process management. Demonstrated success in establishing governance structures or managing intake of workflows. Strong collaboration, communication, and organizational skills. Ability to manage complexity and problem-solve in a fast-paced environment. Search Department Select... Office Select... 76 jobs Administrative Services Job Account Coordinator, PBA Denver, Colorado, United States Account Coordinator, PBM New New York, New York, United States Account Executive, Health Systems New Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Account Executive, PBA Services Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Account Executive, PBM New York, New York, United States Account Executive, PBM Denver, Colorado, United States Account Executive, PBM Charlotte, North Carolina, United States Account Manager, PBA New New York, New York, United States Account Manager, PBM New York, New York, United States Associate Director, Client Services - Account Executive New Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Clinical Account Manager Remote Government Program Operations Specialist Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Government Programs Analysis & Efficiencies Analyst Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Implementation Project Manager Charlotte, North Carolina, United States Manager, Client Experience Resolution & Optimization (CERO) Denver, Colorado, United States Manager, Client Experience Resolution & Optimization (CERO) New York, New York, United States Manager, Client Experience Resolution & Optimization (CERO) Charlotte, North Carolina, United States Regulatory Change Management Analyst Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Senior Implementation Project Manager Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Senior Manager Government Program Operations (Exchange) Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Clinical Enterprise Job Appeals Technician (temp-to-hire) Remote Claims Adjudication Associate New York, New York, United States Clinical Account Consultant, PBA Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Clinical Programs Business Development Manager New York, New York, United States Clinical Programs Business Development Manager Denver, Colorado, United States Clinical Programs Business Development Manager Charlotte, North Carolina, United States Formulary Operations Pharmacist New Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Formulary Operations Specialist Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Manager, Medical Utilization and Care Management Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Medical Director - Texas Licensed (5pm-9pm CT) Remote Prior Authorization Systems Pharmacist Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Prior Authorization Systems Technician Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Utilization Management Pharmacist (temp-to-hire) Remote Utilization Management Technician (temp-to-hire) Remote Utilization Management Technician (temp-to-hire) Remote Finance Job Manager, Analytics - Business Insights Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Senior Analyst, Analytics - Business Insights Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Senior Analyst, Analytics - Client Reporting New Charlotte, North Carolina, United States Human Resources Job Recruiter (Contract) Denver, Colorado, United States Senior Director, Total Rewards New Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Legal Job Case Development Specialist Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Director/Senior Legal Counsel – Medicare, Healthcare Regulatory & Contracting Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Legal Counsel Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Operations Job Case Underwriter Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Senior Project Manager II, Pharmacy Value Programs Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Underwriting Analyst Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States VP, Provider Reimbursement and Contracting Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Sales and Marketing Job Judi SaaS Sales, VP Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Technology Job AI Evaluation Engineer Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States Associate Product Manager New Charlotte, North Carolina, United States; Denver, Colorado, United States; New York, New York, United States 1 2 Powered by Greenhouse

A meeting lands on your calendar

If they’re a yes, I book the chat. You show up — that’s the whole job-hunt.