Data Specialist - Payer Intelligence

About the role

Roche has established the Global Analytics and Technology Center of Excellence (GATE) to drive analytics & technology driven solutions by partnering with Roche affiliates across the globe. The candidate will have an option to join Chennai or Hyderabad office and would be required to come to office in a hybrid mode - the number of days the candidate is required to be in person in the office lies with the management and might change as required by the business. As a Data Specialist - Payer Intelligence , you will play a critical role in reading, understanding, and assessing the medical and pharmacy policies of US Health Insurance companies (also called payers) based on the criteria defined by the subject matter experts. This role requires excellent communication skills, as the Sr Analyst will be responsible for distilling complex policy information into understandable terms and engaging effectively with stakeholders to ensure compliance and alignment with our objectives. Conduct detailed reviews of medical and pharmacy policies from various US Health Insurance Companies across Commercial, Medicare, and Medicaid plans and formulary validation. Assess these policies in the context of our guidelines & criteria such as payer coverage criteria, formulary status, prior authorization (PA), step therapy (ST), and other utilization management (UM) restrictions as established by the business leads. Utilize analytics tools and methodologies to generate insights, providing recommendations for business improvements. Act as a thought partner, collaborating with internal teams to strategize and optimize business processes & rules based on analytical findings. Clearly communicate findings, implications, and recommendations to internal teams and external partners; ensuring complex information is easily interpretable. Develop and maintain documentation related to policy assessments and compliance activities. Contribute to the internal initiatives, which includes adhoc projects and employee engagement programs. A healthier future drives us to innovate. Together, more than 100'000 employees across the globe are dedicated to advance science, ensuring everyone has access to healthcare today and for generations to come. Our efforts result in more than 26 million people treated with our medicines and over 30 billion tests conducted using our Diagnostics products. We empower each other to explore new possibilities, foster creativity, and keep our ambitions high, so we can deliver life-changing healthcare solutions that make a global impact. Let's build a healthier future, together. Roche is an Equal Opportunity Employer.