PBM Data Analyst

Gainwell Technologies

Gainwell Technologies operates at the forefront of technology to enhance healthcare outcomes for the most vulnerable populations. Employees are valued for their flexibility, and opportunities for professional growth abound through comprehensive development programs and flexible vacation policies. As a PBM Data Analyst, you will join a collaborative team that meets healthcare challenges with innovation.

In this role you can expect to have the responsibilities:

• Support PBM implementations, maintenance, and configuration
• Configure claims adjudication logic within a pharmacy claims system
• Conduct configuration validation and peer review
• Perform ad hoc SQL database requests
• Load rule sheets into PA systems and troubleshoot configuration errors
• Collaborate in testing efforts and ensure business process alignment
• Prepare PBM statistics and reports
• Identify product improvements and submit Change Requests
• Troubleshoot complex claims issues
• Collaborate with product engineers on system issues and enhancements

This role comes with the following benefits:

• Flexible vacation policy
• 401(k) employer match
• Comprehensive health benefits
• Educational assistance
• Leadership and technical development academies

This role requires you to have:

• SQL data and business analysis
• Pharmacy claims data knowledge
• Analytical skills in a technical environment
• Experience with pharmacy updates and benefit plan design
• Strong communication and presentation skills

You would benefit from having:

• Advanced knowledge in Microsoft Excel
• Experience in Medicaid or Medicare environments
• Quality testing experience
• Rule-based configuration knowledge

Gainwell Technologies fosters a diverse and inclusive workplace, ensuring equal opportunity employment regardless of personal characteristics.