Analyst, Data Exchange - Eligibility

About Judi Health Judi Health is an enterprise health technology company providing a comprehensive suite of solutions for employers and health plans, including: Capital Rx , a public benefit corporation delivering full-service pharmacy benefit management (PBM) solutions to self-insured employers, Judi Health™ , which offers full-service health benefit management solutions to employers, TPAs, and health plans, and Judi® , the industry’s leading proprietary Enterprise Health Platform (EHP), which consolidates all claim administration-related workflows in one scalable, secure platform. Together with our clients, we’re rebuilding trust in healthcare in the U.S. and deploying the infrastructure we need for the care we deserve. To learn more, visit Hybrid 3 days (offices in NYC, Denver, CO and Charlotte, NC area) Position Responsibilities Attend new client implementation meetings with external partners to discuss eligibility requirements and protocols Recommend eligibility file formats to external partners and coordinate receipt and processing of eligibility data Act as a healthcare data subject matter expert on Eligibility guidelines and Electronic Data Interchange (EDI) protocols Serve as a point of coordination for member eligibility issue identification and issue resolution with internal teams and external partners Identify and triage eligibility issues and support the resolution of all errors related to transferring, loading, and management of eligibility data Proactively monitor system status and eligibility data to quickly identify potential abnormalities that might impact quality and accuracy Ensure that all issues and errors are resolved using designated operating standards and within defined service levels Assist with the validation of eligibility data integrity through regular audits and reconciliation processes Ensure accurate and timely entry of group/plan structure determinations for benefits and enrollment All employees are responsible for adherence to the Judi Health Code of Conduct including reporting of noncompliance. Required Qualifications Bachelor’s degree 1+ years of previous work experience, preferably in PBM, Healthcare, Data Exchange, and Eligibility Ability to match key PBM concepts and data fields across various systems and file layouts to ensure consistency and accuracy of data transfers Ability to analyze complex business problems to discover and resolve root causes Proficiency in SQL, Excel, JSON and other technical data skills preferred Strong communication skills with the ability to develop effective work relationships with internal and external stakeholders Self‑motivated and detail-oriented problem solver Ability to handle multiple competing priorities in a dynamic environment and collaborate in a team We provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws. #J-18808-Ljbffr Capitalrx