PBM Operations Associate
$65,000–$85,000 year
On-siteMiami, Florida, United States
Job Summary
Support eligibility, accumulator, and claims extract file feeds by ensuring data is received, processed, and delivered accurately and on time. Manage interfaces from implementation through ongoing operations, collaborating with engineering, client success, and benefit administration to maintain system compliance. Monitor downstream vendor feeds and third-party integrations to troubleshoot issues and escalate deliverables as needed. Maintain accurate documentation of internal controls and processes while serving as a day-to-day resource for data inquiries. Note that peak seasons, such as open enrollment, may require additional hours. This role sits within the Data Operations team at Rightway, a PBM firm dedicated to harmonizing healthcare and reducing costs for employers.
Required Qualifications
- Bachelor's degree
- 2-4 years of experience in healthcare operations, PBM, health plan, or data/eligibility operations
- Working knowledge of Excel
- Ability to research and troubleshoot data discrepancies
- Eligibility, accumulator, or claims file feed experience
- Detail-oriented
- Organized
- Strong sense of ownership
- Ability to work in a fast-paced environment with shifting priorities
- Comfortable learning new systems and platforms
- Consultative with internal and external stakeholders
- Passion for healthcare
- Relentless devotion to the goal of harmonizing healthcare
- Empathetic approach to every individual
- Ingenuity and resourcefulness when faced with tough problems
- Spirit of open discourse
- Determination to strive for better
- Persistence
- Guts, resilience, initiative, and tenacity
- Kind, respectful, and solution-oriented approach
- Accountability to clients and members' success
Desired Qualifications
- Relevant experience considered for exceptional candidates
- Entry-level candidates with strong analytical skills
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