ProAct PBM Integration Specialist
2 days ago
Job Summary: The ProAct PBM Integration Analyst will support the configuration, testing, and maintenance of partner integrations and claim record analysis and remediation.
Responsibilities:
The Integration Analyst will be responsible for working with new and existing partners in the development and administration of ProAct's core business processes related to accumulators. This includes working with TPAs, electronic transmissions of various file types, and reporting needs. The Analyst will also work with cross-functional teams to systematically integrate and support new partners into standard accumulator business processes.
Key Duties:
- Support the execution of all accumulator operations and interfaces from implementation through ongoing operations and maintenance.
- Responsible for working with new and existing partners in the development and administration of ProAct's core business processes related to accumulators.
- Work with cross-functional teams to systematically integrate and support new partners into standard accumulator business processes.
- Partner with development to test custom programming related to processing and automating accumulator data.
- Analyze business data to perform root cause analysis on data issues as they occur.
- Explain requirements and processes to internal/external technical and business partners in a variety of ways (use cases, logical diagrams, flow charts).
- Responsible for completing all mandatory and regulatory training programs.
Requirements:
The ideal candidate will have a Bachelor's degree and 1-3 years of PBM experience in claims or insurance operations. Pharmacy Technician or related experience is highly desirable.
Skills Required:
- Ability to understand behavior of claims systems, file feeds, and other elements related to processing accumulator data.
- Ability to identify data quality issues and define/implement corrective solutions.
- Identify opportunities and recommend changes to IT that will help ensure optimal performance in our database and systems environment.
- Coordinate activities, changes, and communication with internal groups and business partners.
- Ability to handle multiple tasks and changing priorities in a fast-paced, rapidly growing environment.
- Excellent verbal and written communication skills.
- Self-motivated with excellent customer service and problem-solving ability.
- Vigilance in adherence to system and industry security protocols.
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