Sr. Network Pricing Operations Analyst III

Position Summary:
The candidate needs to be local within the Metropolitan Phoenix or surrounding area so they can work onsite IF future business conditions or needs change. Potential overtime may be required late in the year for seasonal high volume workflow. This role requires a safe and clean work area, and needs to be secure from the general public to maintain confidentiality in accordance with corporate *** policies (including HIPAA). Maintaining active phone service for professional business use is required for the role. Functional, high speed internet service for remote VPN access is required and the candidate must be able to direct-connect via Ethernet cable to their internet modem or router in order for our internal databases to work correctly and efficiently.**

This assignment is to provide operational project support to assess different information inputs (moderate to complex data) that will be used in various pricing initiatives. The role will aggregate the data based on defined requirements to a single output for consumption by other areas in the organization. Strict attention to detail is essential to the role - the final results could be subject to future audits. The candidate will use (but not all-inclusive) MS Office Suite (Excel, Outlook, Teams, and Word), AS400 and Salesforce. Other potential project initiatives include (but not limited to) reconciliation of project data, process improvement, documentation, and process flows. Must be well organized and able to accurately prepare, catalog and electronically store information. Demonstrably strong communication skills are required to work with different business partners (e.g., Underwriting/Account Team or Sales) through the assignment life cycle.

Duties:

This non-IT operations position will be working within a team that is responsible for the timely and accurate implementation of client pricing. We build pricing outputs that cover several lines of business which include Employer, Health Plan, and Government business for pharmacy claims adjudication.

-This assignment is to provide operational project support to assess different information inputs (moderate to complex data) that will be used in various pricing initiatives.
-The role will aggregate the data based on defined requirements to a single output for consumption by other areas in the organization.
-Strict attention to detail is essential to the role - the final results could be subject to future audits.
-The candidate will use (but not all-inclusive) MS Office Suite (Excel, Outlook, Teams, and Word), AS400 and Salesforce.
-Other potential project initiatives include (but not limited to) reconciliation of project data, process improvement, documentation, and process flows.
-Must be well organized and able to accurately prepare, catalog and electronically store information.
-Demonstrably strong communication skills are required to work with different business partners (e.g., Underwriting/Account Team or Sales) through the assignment life cycle.
-Will participate in virtual meetings (and possible future onsite meetings when deemed necessary).

The candidate needs to be local within the Metropolitan Phoenix or surrounding area so they can work onsite IF future business conditions or needs change.

-Potential overtime may be required late in the year for seasonal high volume workflow.
-This role requires a safe and clean work area, and needs to be secure from the general public to maintain confidentiality in accordance with corporate *** policies (including HIPAA).
-Maintaining active phone service for professional business use is required for the role.
-Functional, high speed internet service for remote VPN access is required and the candidate must be able to direct-connect via Ethernet cable to their internet modem or router in order for our internal databases to work correctly and efficiently.** (NO HOTSPOTS)

Experience:

-Prior healthcare experience preferred.
-Working in a PBM environment or equivalent, claims experience or claims auditing background a plus.
-Demonstrable experience in data analysis is key; excellent verbal and written communication skills with the ability to translate information from and to different knowledge levels in the organization (including Leadership) is essential.
-Experience in project participation in moderate to complex projects is preferred.
-Having worked in a fast paced, volume driven environment is also preferred. Exhibition of compliance and audit fundamentals preferred.

Education:

High School Diploma or GED required. Bachelors degree in related field or equivalent work experience preferred. Business or Finance degree or auditing background