Responsibilities
Prepare, validate, and load member data files in accordance with established processes, layouts and schedules
Coordinate internal handoffs of files to downstream teams
Review files for completeness, formatting accuracy, and data integrity prior to release
Track timelines and flag risks or delays early
Support issue resolution by identifying root causes and partnering with internal stakeholders
Adhere to established controls, deadlines, and audit requirements
Required Qualifications
- 1–3 years of experience in Pharmacy Benefit Management (PBM), healthcare administration, or a related healthcare operations environment.
- Experience working with large datasets and high-volume transactional data, including data review and validation.
- Demonstrated ability to identify, investigate, and resolve data discrepancies, processing errors, and operational issues.
- Experience with workload through a queue-based work management system while meeting established service-level expectations.
- Strong attention to detail with a proven track record of delivering accurate, high-quality work under tight deadlines.
- Ability to work effectively in a fast-paced, high-volume environment with changing priorities.
- Proven ability to multitask and independently prioritize workload to meet business objectives.
- Strong understanding of process adherence, quality standards, and operational controls.
- Ability to manage multiple tasks, priorities, and projects simultaneously while maintaining accuracy and efficiency.
- Effective written and verbal communication skills, with the ability to clearly document issues, escalate concerns, and recommend process improvements.
- Proficiency in Microsoft Excel, including sorting, filtering, data validation, and basic data analysis functions.
Preferred Qualifications
- Experience with QL Mainframe
- Understanding of the PBM industry
- Familiarity with RxClaim and/or AS400
- Proficiency in Microsoft Access
- Ability to troubleshoot file errors, formatting issues, or data mismatches
- Bachelor’s Degree
Education
- High School Diploma or G.E.D.
Rate:
Not specified
Location:
Remote
IR35 Status:
Outside
Remote Status:
Remote
Industry:
Data & Analytics
Seniority Level:
Mid-Level