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PBM Integration Specialist

2 months ago

Syracuse, New York, United States ProAct - PBM Full time
Job Summary

The PBM Integration Analyst plays a critical role in supporting the configuration, testing, and maintenance of partner integrations and claim record analysis and remediation for ProAct - PBM.

Key Responsibilities
  • Support the execution of all accumulator operations and interfaces from implementation through ongoing operations and maintenance.
  • Collaborate with new and existing partners to develop and administer ProAct's core business processes related to accumulators.
  • Work with cross-functional teams to 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.
  • Communicate requirements and processes to internal and external technical and business partners.
  • Complete all mandatory and regulatory training programs.
Requirements
  • Bachelor's degree preferred; relevant experience considered for exceptional candidates.
  • Pharmacy Technician or related experience highly desirable.
  • 1-3 years of PBM experience in claims or insurance operations.
Job Skills
  • Ability to understand claims system behavior, file feeds, and other elements related to processing accumulator data.
  • Ability to identify data quality issues and define/implement corrective solutions.
  • Identify opportunities to improve IT processes and procedures.
  • Coordinate activities, changes, and communication with internal groups and business partners.
  • Ability to handle multiple tasks and changing priorities in a fast-paced environment.
  • Excellent verbal and written communication skills.
  • Self-motivated with excellent customer service and problem-solving ability.