Full-Time Member Data Analyst

The fundamentals for the job…

• Assess file load rejects and threshold limit conditions, identify root cause and take action to remediate
• Act on file alert conditions and remediate (e.g. missing file)
• Monitor and track file processing, ensure adherence to client schedules and SLAs
• Perform quality assurance review of data loads (e.g. review load reports, sampling of data) and take corrective action if data issues are identified
• Manage the Accumulator and Eligibility review and reconciliation processes to ensure Abarca and client systems match.
• Complete analysis and provide findings for assigned client data requests within SLA response time
• Ensure adherence of existing controls around data exchange.
• Use analytical tools, such as SQL to conduct data analysis, respond to client requests and identify client-specific solutions.
• Identify improvements to existing client data exchange processes and communicate those solutions to technical and non-technical audiences
• Collaborate with internal teams on client implementations and actively participate with internal workgroups to support activities such as testing client file loads and extracts, review of load reports, documenting results and share with internal team, etc.

What we expect of you 

The bold requirements…

• Bachelor 's Degree or Master’s Degree in a related area. (In lieu of a degree, equivalent relevant work experience may be considered.)
• 3+ years of experience with PBM or health plan data exchange (EDI/ETL) functions.
• Experience developing SQL queries.
• Experience related to relational database architecture and data standards.
• Excellent oral and written communication skills.
• We are proud to offer a flexible hybrid work model which will require certain on-site work days (Puerto Rico Location Only).
• This position requires availability to work in a specified time zone, accommodating the business needs of our clients and team members based in the in the determined time zone.
• This position requires availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands.

Physical requirements…

• Must be able to access and navigate each department at the organization’s facilities.
• Sedentary work that primarily involves sitting/standing.