We’re partnering with a growing healthcare technology company that’s building smarter, more flexible pharmacy benefit solutions. They’re looking for a Pharmacy Benefit Analyst who thrives in the details and understands that precision here isn’t optional, it’s everything.
This role sits at the heart of product execution. You’ll take complex client benefit designs and bring them to life inside the adjudication system, making sure everything is configured correctly, tested thoroughly, and ready to perform from day one. Think of it as part architect, part quality control, part problem-solver.
What You’ll Do
Translate client benefit requirements into accurate system configurations across plan design, formularies, copays, pricing, networks, and clinical programs
Build and maintain benefit plans within the claims adjudication system
Validate configurations before go-live, catching issues early so claims run cleanly from the start
Serve as a go-to resource for internal teams on benefit design questions tied to your accounts
Troubleshoot adjudication issues and partner with technical and operations teams to resolve them quickly
Keep clean, organized documentation of all configurations and updates
Support implementations and open enrollment changes, managing timelines and deliverables
Monitor plans post-launch to ensure ongoing accuracy and alignment with client contracts
What You Bring
1–3 years of experience in claims adjudication or benefit configuration within a PBM environment
Solid understanding of pharmacy benefit structures like formularies, copay tiers, prior authorization, step therapy, and quantity limits
Strong Excel skills, you’re comfortable working with data, running lookups, and making sense of complex information
High attention to detail with a methodical, quality-first mindset
Ability to manage multiple priorities without losing accuracy
Clear communication skills, especially when translating technical requirements into actionable work
Bonus Points
Experience working directly within pharmacy adjudication systems
Familiarity with NCPDP data elements
Why This Role
If you like work where the details actually matter and where getting it right has a real downstream impact, this is that kind of role. You’ll be a key player in making sure clients’ benefits function exactly as designed, no surprises, no fire drills.
The Opportunity
We’re partnering with a growing healthcare technology company that’s building smarter, more flexible pharmacy benefit solutions. They’re looking for a Pharmacy Benefit Analyst who thrives in the details and understands that precision here isn’t optional, it’s everything.
This role sits at the heart of product execution. You’ll take complex client benefit designs and bring them to life inside the adjudication system, making sure everything is configured correctly, tested thoroughly, and ready to perform from day one. Think of it as part architect, part quality control, part problem-solver.
What You’ll Do
Translate client benefit requirements into accurate system configurations across plan design, formularies, copays, pricing, networks, and clinical programs
Build and maintain benefit plans within the claims adjudication system
Validate configurations before go-live, catching issues early so claims run cleanly from the start
Serve as a go-to resource for internal teams on benefit design questions tied to your accounts
Troubleshoot adjudication issues and partner with technical and operations teams to resolve them quickly
Keep clean, organized documentation of all configurations and updates
Support implementations and open enrollment changes, managing timelines and deliverables
Monitor plans post-launch to ensure ongoing accuracy and alignment with client contracts
What You Bring
1–3 years of experience in claims adjudication or benefit configuration within a PBM environment
Solid understanding of pharmacy benefit structures like formularies, copay tiers, prior authorization, step therapy, and quantity limits
Strong Excel skills, you’re comfortable working with data, running lookups, and making sense of complex information
High attention to detail with a methodical, quality-first mindset
Ability to manage multiple priorities without losing accuracy
Clear communication skills, especially when translating technical requirements into actionable work
Bonus Points
Experience working directly within pharmacy adjudication systems
Familiarity with NCPDP data elements
Why This Role
If you like work where the details actually matter and where getting it right has a real downstream impact, this is that kind of role. You’ll be a key player in making sure clients’ benefits function exactly as designed, no surprises, no fire drills.
