Data Integration Analyst

Description

What you’ll do

In a few words… Abarca is igniting a revolution in healthcare. We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning…

As a Data Integration Analyst, you are the day-to-day engine of our client data operations. You independently monitor inbound and outbound data exchanges, investigate file load issues, and ensure that client eligibility, accumulator, and claims data flows accurately and on time. Your analytical skills and keen attention to detail are critical to identifying root causes, communicating impacts, and driving resolution — all while building your expertise in PBM data systems and client integrations.

The fundamentals for the job…

• Assess file load rejects and threshold limit conditions, identify root causes, and take action to remediate issues independently.
• Act on file alert conditions (e.g., missing or delayed files) and drive timely remediation.
• Monitor and track file processing to ensure adherence to client schedules and service level agreements.
• Perform quality assurance reviews of data loads — including review of load reports and data sampling — and take corrective action when data issues are identified.
• Manage Accumulator and Eligibility review and reconciliation processes to ensure alignment between Abarca and client systems.
• Complete analysis and provide findings for assigned client data requests within SLA response timeframes.
• Use SQL and other analytical tools to conduct data analysis, respond to client requests, and identify client-specific solutions.
• Read and interpret flat-file layouts (eligibility, accumulators, claims) to identify mapping gaps and integration issues.
• Ensure adherence to existing controls around data exchange.
• Document investigation steps, findings, and resolution actions in ADO, CRM, or Confluence to ensure traceability.
• Identify improvements to existing client data exchange processes and communicate those solutions to technical and non-technical audiences.
• Collaborate with internal teams on client implementations, including testing file loads and extracts, reviewing load reports, and sharing results.
• Perform any additional tasks or special projects as assigned.

Requirements

What we expect of you

The bold requirements…

• Bachelor's Degree or Master's Degree in a related area. (In lieu of a degree, equivalent relevant work experience may be considered.)
• 3+ years of experience with PBM or health plan data exchange (EDI/ETL) functions.
• Experience developing SQL queries for data analysis and validation.•Experience related to relational database architecture and data standards.
• Solid working knowledge of PBM data domains including eligibility, accumulators, benefit groups, and claims.
• Experience with Darwin or comparable PBM system platforms.
• Excellent oral and written communication skills.
• We are proud to offer a flexible hybrid work model which will require certain on-site work-days (Puerto Rico Location Only)
• This position requires availability to work in a specified time zone or working schedule, accommodating the business needs of our clients and team members.
• This position may require availability for on-call hours, including evenings, weekends, and holidays, to promptly address emergent issues or provide necessary support as dictated by operational demands (if applicable).

Nice to haves...

• Experience with dashboarding tools or Python for data validation and reconciliation.
• Familiarity with healthcare industry data standards and PBM regulatory frameworks (e.g., Medicare Part D, CMS).

Physical Requirements

• Must be able to access and navigate each department at the organization’s facilities.
• Sedentary work that primarily involves sitting/standing.

At Abarca we value and celebrate diversity. Diversity, equity, inclusion, and belonging are guiding principles of Abarca and ensure Abarca’s workforce reflects the communities it serves. We are proud to 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.

Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify. Abarca Health LLC does not sponsor employment visas at this time.

The above description is not intended to limit the scope of the job or to exclude other duties not mentioned. It is not a final set of specifications for the position. It’s simply meant to give readers an idea of what the role entails.