Benefits Configuration Analyst

About This Opportunity

We are representing a confidential pharmacy benefits technology organization in their search for a Benefits Configuration Analyst. Our client is transforming how pharmacy benefits are managed through innovative technology platforms and cost-saving solutions. This remote role offers the opportunity to work with cross-functional teams supporting benefit plan implementation and configuration for a rapidly growing client base.

As a Benefits Configuration Analyst, you'll build and maintain pharmacy benefit plans across various platforms, ensuring accuracy and quality throughout the implementation lifecycle. You'll work directly with clients to understand their benefit requirements and collaborate with internal teams to resolve member inquiries and optimize workflows.

Responsibilities

• Build and maintain pharmacy benefit plans for client groups, identifying and understanding plan requirements
• Monitor plan data integrity and organize benefit configuration structure for assigned accounts
• Maintain prior authorizations and step therapy rules
• Grandfather and transition new clients; update formularies based on clinical team direction
• Provide troubleshooting support for claims adjudication processes
• Support new client implementations including go-live testing, post go-live auditing, and accuracy confirmation
• Collaborate with member support and customer success teams to resolve benefit-related inquiries promptly
• Communicate project status and escalate issues appropriately while identifying workflow efficiency improvements
• Assist in determining and implementing process improvement efforts

What We're Looking For

• 4+ years of experience in payer/claims and benefit configuration required
• Strong analytical skills with advanced Microsoft Excel proficiency
• Excellent communication abilities across face-to-face meetings, conference calls, and written correspondence
• Self-starter mentality with ability to make informed decisions and find creative approaches to complex challenges
• Solutions-oriented problem solver with execution-focused, efficiency-driven mindset
• Flexible, dependable, and adaptable with ability to perform under pressure in a fast-paced environment
• Proven track record of delivering on commitments

How We Work With You

Candidates apply directly through Get A Job.ai. Our talent team will conduct an initial screening to understand your background and qualifications. We then submit qualified candidates to our client for consideration. Please do not attempt to contact the client directly, as all communication flows through our recruiting process to ensure the best candidate experience.

Location & Employment Type

Location: Remote (USA)
Employment Type: Full-time

Pay

Compensation details will be discussed with qualified candidates during the screening process based on location zone and experience level.

Equal Employment Opportunity: Get A Job.ai is committed to fostering an inclusive recruiting process. We partner with clients who value diversity and provide equal employment opportunities to all qualified applicants.