Analyst, Data Exchange - Eligibility (Healthcare)

TL;DR

Analyst, Data Exchange - Eligibility (Healthcare): Managing eligibility data flows and EDI protocols for health technology platforms with an accent on data integrity and stakeholder coordination. Focus on identifying root causes of eligibility issues, optimizing file formats, and ensuring seamless data transfer between external partners and internal systems.

Location: Must be based in the US. Remote (for non-locals) or Hybrid (for those local to Denver, CO or NYC area).

Salary: $76,800 - $121,000 USD

Company

Enterprise health technology company providing a comprehensive suite of pharmacy and health benefit management solutions including the Judi Enterprise Health Platform.

What you will do

• Coordinate eligibility requirements and protocols with external partners during client implementations.
• Recommend and manage eligibility file formats and Electronic Data Interchange (EDI) protocols.
• Identify, triage, and resolve errors related to the transfer and loading of eligibility data.
• Proactively monitor system status to detect abnormalities impacting data quality and accuracy.
• Perform regular audits and reconciliation processes to validate data integrity.
• Manage group and plan structure determinations for benefits and enrollment.

Requirements

• Bachelor’s degree.
• 1+ years of experience, preferably in PBM, Healthcare, or Data Exchange.
• Must be based in the United States.
• Proficiency in SQL, Excel, and JSON.
• Ability to analyze complex business problems to discover root causes.
• Strong communication skills for collaborating with internal and external stakeholders.

Culture & Benefits

• Competitive base salary ranges tailored to location (Remote US, New York, or Denver).
• Opportunity to work in a diverse and inclusive workplace.
• Flexible work arrangement (Remote or Hybrid).
• Role within a high-impact health technology environment rebuilding trust in US healthcare.