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Position Summary:
- Act as the primary liaison between Data Operations and business-facing teams, managing eligibility and accumulator file exchange.
- Own operational health of SFTP connections, file transfers, and automations to reduce manual handling.
Key Responsibilities:
- Administer SFTP environments in Couchdrop, monitor file cycles, and coordinate new partner setups.
- Build automations, monitoring alerts, and reconciliation processes to resolve claims and accumulator discrepancies.
- Serve as the point of contact for TPA partners, drive issue intake and impact analysis, and maintain tracking dashboards.
Qualifications:
- 5+ years in business/data operations with at least 3 years in PBM, pharmacy benefits, or health plan operations.
- Experience with pharmacy claims adjudication, TPA accumulator ledgers, and healthcare data exchange.
- Strong project management, communication, and AI-assisted tool development skills, with HIPAA awareness.
AffirmedRx
AffirmedRx is a pharmacy benefit management company on a mission to improve health care outcomes by bringing clarity, integrity, and trust to the industry. They are committed to transparency, clinical approaches, and state-of-the-art technology, fostering a culture where people thrive and values like trust, accountability, and innovation are central.