Business Analyst, Data Operations (Healthcare)

Location: Remote. Willingness to travel 10%–20% is required.

Company

hirify.global improves healthcare outcomes through transparent, clinically focused pharmacy benefit management supported by modern technology.

What you will do

• Manage SFTP connections, credentials, folder structures, schedules, and eligibility and accumulator file exchanges in Couchdrop.
• Build and maintain automated file workflows, monitoring, alerts, documentation, and recovery procedures.
• Reconcile member claims in pharmacy claims adjudication platforms with TPA and medical carrier accumulator ledgers.
• Serve as the operational contact for TPAs, client managers, and patient care advocates, coordinating issue resolution and proactive status updates.
• Lead data operations projects including TPA onboarding, file layout transitions, and automation initiatives.
• Identify, validate, and deploy AI-assisted tools while documenting data use, limitations, and security considerations.

Requirements

• Bachelor’s degree in business, healthcare administration, information systems, or a related field, or equivalent experience.
• 5+ years of experience as a business analyst, data operations analyst, or similar, including at least 3 years in PBM, pharmacy benefits, or health plan operations.
• Hands-on experience with pharmacy claims adjudication platforms, claims research, reversals, adjustments, and accumulator discrepancy reconciliation.
• Experience managing SFTP environments and building file-transfer automations; Couchdrop experience is strongly preferred.
• Experience working with TPAs or external partners, leading cross-functional projects, and maintaining dashboards or tracking tools.
• Understanding of HIPAA and secure handling of protected health information, plus strong analytical, organizational, and communication skills.

Nice to have

• PMP or similar project management certification.
• Experience with LLM-based assistants, prompt design, or AI-assisted automation.
• Experience with Excel, Power BI, Smartsheet, Jira, or similar tracking tools.

Culture & Benefits

• Opportunity to improve pharmacy benefits and patient outcomes.
• Mission-driven culture centered on trust, accountability, innovation, and supportive collaboration.
• Competitive compensation with health, dental, vision, and other benefits.
• Remote work environment with expectations for professional focus and effective collaboration.