Express Scripts Lead Business Analyst in St. Louis, Missouri

POSITION SUMMARY

The FWA Analytics team works to identify potential member and physician fraud, waste or abuse for all paying clients. Additionally, the team creates proactive queries that target outliers within the entire Express Scripts network.The Business Analyst is primarily responsible for identifying and supporting the design, development, analysis, interpretation and communication of that data/information used to identify and monitor Fraud, Waste and Abuse process performance.

ESSENTIAL FUNCTIONS

  • Responsible for querying for outliers in client’s data using a variety of queries to identify members/prescribers with patterns or problems believed to be actionable and providing recommendation to investigators for further research. This is performed from both tips from the Fraud Tip Hotline and proactive analytics performed on a monthly basis.
  • Analysis of fraud schemes in specific geographic areas and development of queries based off discernible criteria.
  • Development of new queries and/or enhancement of current queries.
  • Mentor internal customers to identify root cause, data needed, use of analytical tools, analyze and interpret performance metrics.
  • Work collaboratively with various departments to support program design and launch to meet timeline. Maintain a variety of meet performance metrics.

QUALIFICATIONS

  • Bachelor’s degree in related field or 8 to 11 years of experience.
  • 2-5 years relevant experience with Bachelor’s Degree or Master’s degree and 0-3 years of relevant experience.
  • CPhT preferred

ABOUT THE DEPARTMENT

If your niche is in financial reporting and analysis, underwriting, cash management, audit, or investor relations, our Finance department may be a perfect fit for you. Our teams within Finance work together to ensure our spending stays on track, and that we remain a profitable industry leader. We’re always on the lookout for innovative people who think outside the box to join our team.

ABOUT EXPRESS SCRIPTS

Advance your career with the company that makes it easier for people to choose better health.

Express Scripts is a leading healthcare company serving tens of millions of consumers. We are looking for individuals who are passionate, creative and committed to creating systems and service solutions that promote better health outcomes. Join the company that Fortune magazine ranked as one of the "Most Admired Companies" in the pharmacy category. Then, use your intelligence, creativity, integrity and hard work to help us enhance our products and services. We offer a highly competitive base salary and a comprehensive benefits program, including medical, prescription drug, dental, vision, 401(k) with company match, life insurance, paid time off, tuition assistance and an employee stock purchase plan.

Express Scripts is an equal opportunity employer/disability/veteran.

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