Hyderabad, Telangana, India
Onsite
At Roche you can show up as yourself, embraced for the unique qualities you bring. Our culture encourages personal expression, open dialogue, and genuine connections, where you are valued, accepted and respected for who you are, allowing you to thrive both personally and professionally. This is how we aim to prevent, stop and cure diseases and ensure everyone has access to healthcare today and for generations to come. Join Roche, where every voice matters.
Data Specialist - Payer Intelligence
Roche India – Roche Services & Solutions
Chennai / Hyderabad
A healthier future. It’s what drives us to innovate. To continuously advance science and ensure everyone has access to the healthcare they need today and for generations to come. Creating a world where we all have more time with the people we love.
Who we are
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.
The Opportunity:
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.
Who you are:
You hold a bachelor's degree in Life Sciences (Pharmacology, Dentistry, or a related field) and 2 to 5 years of experience in Pharma/Healthcare (pharmacovigilance, insurance, health IT).
Certification in SQL, Power BI, or similar technical skills is preferred
Prior experience in the corporate healthcare industry is required.
Experience in healthcare policy, insurance, compliance, or related areas with solid knowledge of US healthcare regulations is highly desirable.
Familiarity with secondary data sources such as FDA databases, Redbook, and clinical labels is preferred.
Strong analytical mindset with keen attention to detail, able to communicate complex information clearly and concisely.
Excellent interpersonal and communication skills with proven stakeholder engagement skills; effective team member in a cross functional and dynamic environment.
Proficient in Microsoft 365 and Google Suite Workspace.
Technical expertise in Excel required; working knowledge of SQL and Python or similar programming language is good to have.
Demonstrated ability to work independently as well as collaboratively in a dynamic environment, managing multiple priorities effectively.
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.
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