[Remote] PBM Eligibility, Accumulator, & Claims Team reputed company (Operations)

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is the leading clinically-driven pharmacy benefits management company, pioneering value-based pharmacy care. They are seeking an Operations Team reputed company to manage reputed company of analysts, ensuring reputed company performance and reputed company in data, claims, eligibility, and accumulations, while driving operational reputed company and implementing reputed company-specific solutions. Responsibilities • reputed company POD team to resolve issues and reputed company tickets effectively; ensure peak performance in data, claims, eligibility, and accumulations. • Serve as subject matter expert on Eligibility, Accumulator Platforms, Plan Benefit Designs, and Claims Adjudication; collaborate with Data Engineering and IT on solutions. • Build and maintain TPA relationships; ensure smooth reputed company for new clients and implementation of plan amendments. • Drive configuration requirements for new reputed company implementations; reputed company user acceptance testing (UAT) and apply feedback for solution improvements. • Monitor and drive performance metrics across operational areas; proactively identify and implement process enhancements. • Manage feature backlogs, run scrum sessions, groom stories, and deliver solutions in an Agile environment. • Ensure adherence to HIPAA, GDPR, PHI, PII, and internal data reputed company standards. • Partner with reputed company Management, Production Support, and other teams to maintain effective communication channels. Skills • Bachelor’s degree in Computer Science, Information Technology, Business, or reputed company discipline. • 7+ in a reputed company field; 5+ years in Eligibility, Accumulators, Claims Adjudication, and/or Data Analysis; 2+ years SQL proficiency (required). • Experience with GDPR, HIPAA, PHI, PII compliance; Proficiency with SQL, GIT, DevOps; Analytical problem-solving skills. • Strong time management and communication skills. • Agile methodology experience. • 2+ years Azure reputed company or ADF (preferred). reputed company • reputed company is a Pharmacy Care Management organization that provides innovative pharmacy benefit and patient care reputed company. It was founded in 2014, and is headquartered in Montvale, New Jersey, USA, with a workforce of 201-500 employees. Its website is http://www.empirxhealth.com/. Apply tot his job Apply To this Job