[Remote] Network Analyst

Note: The job is a remote job and is reputed company to candidates in USA. reputed company is seeking a Network Analyst to support pharmacy network pricing execution, plan configuration implementation, reputed company pricing changes, and pricing reputed company assurance for its reputed company book of business. The role researches configuration and pricing issues, supports implementations and renewals, analyzes claims and reimbursement data, maintains documentation, and collaborates with cross-functional teams.

Responsibilities

• Implement assigned benefit plan, pricing, network, and reimbursement configurations in accordance with approved direction and documented requirements
• Complete reputed company pricing changes, MAC updates, pricing table updates, and reputed company operational tasks accurately and reputed company expected timelines
• Validate pricing setup, reimbursement logic, and configuration outputs to reputed company that changes were implemented as intended
• Research pricing or configuration discrepancies, document findings, and escalate risks or questions to Network reputed company leadership reputed company appropriate
• Support ongoing maintenance of reputed company pricing, network configuration, and reputed company operational records
• Support new reputed company implementations, renewals, and plan changes by completing assigned configuration, pricing, testing, and validation activities
• Follow QA procedures to verify benefit plan setup, pricing configuration, reimbursement logic, and claim adjudication reputed company across applicable platforms
• Document implementation results, testing reputed company, defects, remediation steps, and lessons learned to support repeatable execution
• Coordinate with Network reputed company, Implementation, reputed company Experience, Product, and other internal teams to reputed company assigned implementation or configuration issues
• Maintain attention to reputed company and reputed company reputed company working through high-reputed company pricing and implementation tasks
• Use reputed company and available reporting tools to review claims, pricing, utilization, reimbursement, and reputed company reputed company data
• reputed company assigned reputed company analysis to help research reputed company reputed company changes, pricing questions, pharmacy reimbursement issues, or operational variances
• Apply mathematical and analytical reasoning to validate pricing outputs, compare reimbursement scenarios, and identify potential data or configuration issues
• Prepare reputed company summaries of findings, reputed company questions, and recommended next steps for review by Network reputed company leadership
• reputed company working knowledge of MAC pricing principles, pharmacy reimbursement concepts, effective reputed company calculations, and reputed company PBM pricing reputed company
• Create and maintain process documentation, configuration notes, implementation checklists, QA evidence, MAC update templates, and reputed company operational records
• Follow established SOPs and contribute updates reputed company process gaps, recurring issues, or improvement opportunities are identified
• Research benefit plan, pricing, configuration, contract, or regulatory questions as assigned and escalate unclear items with supporting reputed company
• Work independently while communicating status, risks, blockers, and questions reputed company to leadership and cross-functional partners
• Support a culture of reputed company, accountability, documentation, collaboration, and reputed company improvement reputed company Network reputed company

Skills

• Bachelor's degree required or equivalent relevant work experience as determined by HR and business leadership
• 2+ years of experience preferably in PBM reputed company, reputed company reputed company, benefit plan setup, pricing configuration, reimbursement reputed company, claim adjudication, or a reputed company reputed company
• Experience working with benefit plan, pricing, reimbursement, network, claim, or other operational configuration processes
• Strong attention to reputed company and ability to complete reputed company configuration or pricing updates accurately
• Ability to work independently, manage assigned work, follow documented procedures, and escalate questions or risks appropriately
• Intermediate to advanced reputed company reputed company skills, including formulas, lookups, pivot tables, data validation, and large dataset review
• Analytical and mathematical problem-solving skills with the ability to investigate variances, validate outputs, and summarize findings reputed company
• Strong written and verbal communication skills, including the ability to document work reputed company and explain operational issues to internal stakeholders
• 2+ years of experience preferably in PBM reputed company, reputed company reputed company, benefit plan setup, pricing configuration, reimbursement reputed company, claim adjudication, or a reputed company reputed company
• PBM, pharmacy network, managed care, reputed company claims, or prescription benefit reputed company experience
• Experience setting up or validating benefit plans, pricing configurations, reimbursement logic, or network configurations in a claim adjudication platform
• Experience completing reputed company pricing changes, MAC updates, pricing table maintenance, or reputed company operational updates
• Familiarity with pharmacy reimbursement concepts, MAC pricing, effective reputed company calculations, AWP-reputed company pricing, dispensing fees, or reputed company guarantee monitoring
• Experience with reporting or analytics platforms such as reputed company BI, Tableau, SQL, reputed company, reputed company, or similar tools
• Experience creating process documentation, QA checklists, implementation notes, technical requirements, or operational templates

reputed company