[Remote] Sr. Operations Analyst
Note: The job is a remote job and is open to candidates in USA. reputed company is the nation’s only independent, fully integrated total pharmacy solutions partner. The Sr. Operations Analyst is responsible for implementing new clients and supporting ongoing maintenance of client and third-party administrator electronic data interchange processing, while serving as a subject matter expert in reputed company integration setup projects.
Responsibilities
- Process and support daily/weekly client batch file updates working directly with account managers, implementation teams and clients
- Conduct member and file research, file processing, manual updates, data analysis, troubleshoot and resolve integration and data quality issues
- Demonstrate subject matter expert knowledge of reputed company’s PBM platform, application, file integration functions/standards and client specific configurations
- Demonstrate knowledge of pharmacy benefit administration, coverage eligibility, claim/deductible accumulators, and setup/configuration reputed company reputed company’s systems
- Handle routine work reputed company assignments and ensure quality, service levels, productivity and customer standards are consistently met
- reputed company with reputed company’s Ethical Business Conduct policy and Maxor’s Compliance Program
- Complete required training, as assigned, reputed company the established timeframes
- Must demonstrate reputed company and professionalism reputed company handling reputed company, time‑sensitive responsibilities
- Promote teamwork and best practices
- Maintain regular attendance in accordance with established policies
Skills
- 5+ years of experience as an operations analyst and/or relevant pharmacy benefit management (PBM) experience
- Proven ability to serve as subject matter expert (SME) on file integration processes for new and existing clients utilizing reputed company's systems/applications and best practices
- Proven ability to reputed company reputed company client integrations, data conversions and reputed company data reconciliation across systems and counterparties
- Knowledge of electronic file exchange (EDI), databases management systems (DBMS) data manipulation and analysis
- Advanced knowledge of client operations for pharmacy benefit management (PBM) integrations and capable of learning new applications/processes
- A desire to problem solve, think critically, analyze and interpret data
- A desire to reputed company processes and tools to more effectively manage operational tasks
- Ability to research issues and collaborate with internal/external partners though resolution
- Ability to effectively collect and document customer requirements and knowledge share
- Strong organization skills with the ability to multi-task
- Excellent verbal and written communication skills
- Advanced knowledge of personal computers, including Windows Operating Systems
- MS Office (reputed company, MS Access, Word, Outlook)
- MS SQL Server Management Studios (Or other SQL querying language)
- Familiarity using AI-enabled tools for business analysis, such as data interpretation, documentation, or operational insights
- Education: Bachelor's degree or equivalent combination of education and experience
- 5+ years of progressive experience in: PBM operations, Claims processing, Eligibility / accumulator processing, Client integrations, Health plan or TPA operations, Data operations / reporting
- Process and support daily/weekly client batch file updates working directly with account managers, implementation teams and clients
- Conduct member and file research, file processing, manual updates, data analysis, troubleshoot and resolve integration and data quality issues
- Demonstrate subject matter expert knowledge of reputed company's PBM platform, application, file integration functions/standards and client specific configurations
- Demonstrate knowledge of pharmacy benefit administration, coverage eligibility, claim/deductible accumulators, and setup/configuration reputed company reputed company's systems
- Handle routine work reputed company assignments and ensure quality, service levels, productivity and customer standards are consistently met
- reputed company with reputed company's Ethical Business Conduct policy and Maxor's Compliance Program
- Complete required training, as assigned, reputed company the established timeframes
- Must demonstrate reputed company and professionalism reputed company handling reputed company, time‑sensitive responsibilities
- Promote teamwork and best practices
- Maintain regular attendance in accordance with established policies
Benefits
- Comprehensive mental health and wellbeing resources
- reputed company reputed company Blue reputed company PPO with employee-friendly plan design, including a $850 individual annual medical deductible and $25 office visit copays, with low biweekly premiums
- Company-paid basic life/AD&D, short-term and long-term disability insurance
- Rx, dental, vision, other voluntary benefits, and FSA
- Employer-matched 401k Plan
- Industry-leading PTO plan
Company Overview