PBM Operations Associate

This is a fully remote position, open to applicants in United States.

📋 Description

• Assist in the execution of eligibility and accumulator file feeds as well as interfaces from the implementation phase through to ongoing operations and maintenance.

• Aid in the claims extract file feeds, ensuring that data is accurate, comprehensive, and delivered to external stakeholders punctually.

• Act as a daily resource for eligibility, accumulator, and claims extract data requirements.

• Collaborate with engineering, client success, implementations, benefit administration, and other internal stakeholders.

• Oversee downstream vendor feeds and third-party integrations, escalating and resolving issues as they arise.

• Investigate and resolve daily inquiries or issues associated with eligibility, accumulators, and claims data feeds.

• Keep precise, up-to-date documentation of processes and internal controls.

• Assume additional responsibilities as business needs change and work extra hours during peak periods as necessary.

⛳️ Requirements

• Bachelor's degree is preferred; relevant experience will be considered for outstanding candidates.

• 2–4 years of experience in healthcare operations, PBM, health plan, or data/eligibility operations; entry-level candidates with strong analytical abilities are encouraged to apply.

• Detail-oriented and organized, demonstrating strong ownership while thriving in a fast-paced environment with changing priorities.

• Willingness to learn new systems and platforms.

• Consultative approach when interacting with internal and external stakeholders.

• Proficient knowledge of Excel.

• Capability to research and resolve data discrepancies.

• Experience with eligibility, accumulator, or claims file feeds.

🏝️ Benefits

• Bonus

• Equity

• Remote work arrangement