At our company, we move fast, adapt quickly, and turn challenges into opportunities—all while keeping quality at the heart of everything we do. We believe that work should be a positive and respectful place, and that with the right mindset, anything is achievable.
Our Vision:
Fulfill the essential promise of pharmacy care and help people to live to their healthiest, happiest, and fullest potential.
Our Mission:
To be the disruptive force that drives meaningful change within pharmacy services.
Summary
As a Benefit Analyst III, you will be accountable to provide support on the client benefit configurations, including coding, testing and implementation. Plan change updates, research tasks and contributing to external auditor reviews round out a routine schedule in this position. Success in this role is demonstrated by accurate client implementations, client satisfaction with plan maintenance, and timely completion of requests.
Essential Duties and Responsibilities
- Provides client satisfaction through accurate benefit configuration design and set up, including consultation and collaboration with external clients, brokers and internal business partners
- Plan maintenance and benefit change requests for existing clients, including updates annually to member cost share and accumulators.
- Manages the pre-assessment of benefit change requests by performing research to ensure plan configuration will meet client specifications, providing options for meeting the client intent.
- Utilize the RxClaim operating system to design, build and maintain client plans and components
- End-to-end testing and validation of plans to ensure plan benefits meet client specifications
- Ability to determine and prioritize client needs to ensure all change requests meet client deadlines
- Research and provide feedback for claim-related inquiries
- Participate in external auditor reviews, including claim research
- Training current team members and any new hires
- Ability to work additional hours as workload dictates
- Additional duties as assigned
Education and Experience
- Bachelor’s degree or equivalent of education and experience
- Proficiency in RxClaim adjudication platform, including experience in PBM benefit design
Knowledge, Skills and Abilities
- Ability to work in a fast-paced environment with minimal instruction and a high degree of accuracy and attention to detail.
- Strong verbal and written communication skills including presentation skills and client relationship management
- Sets priorities and manages workflow to ensure efficient, timely and accurate deliverables.
- Ability to manage and negotiate multiple priorities and deadlines.
- Maintain a cordial and effective relationship with clients and co-workers and work in a team environment.
- Interact with others effectively by utilizing good communication and organizational skills and providing information and guidance, as needed to achieve the business goals of the company.
- Strong Analytical skills.
Work Environment / Physical Demands
This position is in a typical office environment which requires prolonged sitting in front of a computer. Requires hand-eye coordination and manual dexterity sufficient to operate standard office equipment including operation of standard computer and phone equipment. May have occasional high stress when dealing with customers/clients. Some travel may be required.
EOE M/F/D/V – WellDyne and HealthDyne are equal opportunity employer and prohibits discrimination of any kind. All employment decisions are based on business needs, job requirements, and individual qualifications, without regard to race, color, religion, gender, sexual orientation, gender identity, national origin, veteran or disability status, or any other protected status under federal, state, or local law.