Pbm Implementation Jobs in Riverside, CA (NOW HIRING)

Description
JOB DESCRIPTION SUMMARY
The Sales Implementation Analyst reports to the Director, Business Development and owns the sales-to-implementation transition for new business onboarding and current client upsells at Pinnacle Claims Management. This client- and broker-facing role serves as the subject matter expert for implementation requirements, sold product and service validation, onboarding documentation, and operational readiness. The position acts as the primary liaison between Sales, Account Management, brokers, clients, and Installation by leading requirements discovery, confirming scope, identifying operational dependencies, and translating complex client expectations into clear, actionable implementation documentation. This role guides clients and brokers through the onboarding process, clearly articulates why information is required and how it is used, and ensures accuracy, compliance, timeline adherence, and cross-functional readiness. The position plays a critical role in supporting new business growth, current business upselling, revenue activation, implementation efficiency, and overall client experience.
QUALIFICATIONS
• Bachelor's degree in Business, Healthcare Administration, Project Management, or a related field preferred. Five (5) to seven (7) years of experience in health plan operations, client implementation, sales operations, onboarding, business analysis, account management; or an equivalent combination of education and experience.
• Extensive knowledge of health benefit plans, including self-funded products, with a strong
understanding of eligibility, enrollment, plan design, group structure, billing, vendor coordination, reporting, system requirements, and implementation dependencies.
• Demonstrated ability to support complex, multi-product implementations involving medical
administration, PBM, network arrangements, eligibility, billing, wellness, care management, reporting, stop-loss coordination, vendor partners, and client-specific service requirements.
• Experience working directly with brokers, consultants, employer groups, Sales, Account Management, Installation, and cross-functional teams to gather requirements, clarify expectations, resolve gaps, and support implementation readiness.
• Ability to interpret proposal materials, sold service summaries, fee exhibits, implementation
assumptions, plan design requirements, and client-specific service commitments, with the ability to translate those requirements into clear and actionable implementation documentation.
• Strong analytical, organizational, project management, and problem-solving skills, with the ability to manage multiple priorities, deadlines, stakeholders, implementation risks, and revenue activation dependencies in a fast-paced environment.
• Excellent written and verbal communication skills, including the ability to clearly explain complex benefits, operational, technical, and compliance-related information to clients, brokers, Sales,
Installation, and internal leadership.
• Experience using CRM, proposal, document management, workflow, and/or CPQ tools. Project
management, proposal management, self-funding, or employee benefits certifications preferred, including PMP, APMP, CSFS, CEBS, REBC, GBA, or similar industry credentials.
• Internet access provided by a cable or fiber provider with 40 MB download and 10 MB upload speeds.
• Home router with wired Ethernet; wireless connections and hotspots are not permitted.
• A designated room for your office or steps taken to protect company information, such as facing computer toward a wall.
• A functioning smoke detector, fire extinguisher, and first aid kit on site.
DUTIES AND RESPONSIBILITIES
Implementation Ownership & Scope Validation
• Own the front-end sales-to-implementation transition for new business groups and upsold groups,ensuring sold products, services, commitments, and client-specific requirements are clearly defined, validated, and documented prior to implementation build.
• Lead onboarding and requirements discovery calls with brokers, employer groups, Sales, Account Management, and internal stakeholders to confirm sold scope, implementation timelines, operational dependencies, required decisions, and outstanding information.
• Serve as the primary broker/client-facing contact for onboarding requirements, implementation documentation, and sales-to-installation readiness throughout the new business transition.
• Review proposals, renewals, RFP responses, sold service commitments, fee exhibits, plan design summaries, implementation assumptions, and related sales documentation to validate new business scope, identify gaps, and ensure alignment between client expectations and operational capabilities.
• Analyze and translate complex broker/client requirements into actionable implementation instructions across multiple product lines, including medical administration, PBM, networks, eligibility, billing, reporting, wellness, care management, stop-loss, ID cards, and vendor partners.
• Guide brokers, clients, Sales, and Account Management through the onboarding process by clearly explaining required information, why it is needed, how it will be used, and how incomplete or inaccurate information may impact implementation timelines, compliance, operational configuration, and client experience.
• Identify incomplete, conflicting, or unclear requirements and exercise appropriate authority to push back with Sales, Account Management, brokers, clients, or internal stakeholders before advancing the group to Installation.
Risk Management & Documentation Control
• Own the preparation, review, validation, and management of new business onboarding
documentation, implementation requirement materials, and sales-to-installation handoff packages.
• Serve as the final readiness and audit checkpoint prior to implementation handoff, ensuring all required information is complete, accurate, consistent, compliant, and usable by the Installation
department.
• Facilitate communication between brokers, employer groups, Sales, Installation, Account
Management, Finance, Eligibility, Claims, Customer Service, PBM, Wellness, and vendor partners to ensure alignment on requirements, responsibilities, timelines, and outstanding decisions.
• Identify discrepancies, missing information, operational gaps, conflicting commitments, and potential implementation risks; coordinate timely resolution with brokers, clients, Sales, Account Management,leadership, and internal operational teams.
• Escalate implementation barriers, unclear commitments, scope concerns, or at-risk timelines to appropriate leadership while recommending practical options to support resolution.
• Validate that onboarding / renewal materials, requirement documents, CRM records, tracking tools, and implementation handoff packages accurately reflect sold scope, client expectations, and operational requirements.
• Monitor outstanding requirements and unresolved implementation items to prevent downstream delays, rework, client dissatisfaction, or compliance concerns.
Revenue Operations, Reporting & Process Optimization
• Maintain and enhance sales-to-implementation tracking tools, readiness dashboards, intake forms, SOPs, workflow documentation, and reporting to support visibility, accountability, and timely new business activation.
• Track implementation readiness metrics, outstanding requirements, turnaround times, bottlenecks, and at-risk groups to support leadership visibility, prioritization, and timely intervention.
• Analyze recurring onboarding challenges, documentation gaps, workflow inefficiencies, and
implementation delays; recommend and support process improvements to improve speed, accuracy, ]scalability, and client experience.
• Partner with Sales, Account Management, Installation, and operational leadership to strengthen handoff quality, standardize intake expectations, and improve the overall sales-to-implementation workflow.
• Lead onboarding and ongoing training for new and existing team members on new business intake, current business upsells, audit standards, documentation expectations, readiness workflows, and process changes.
• Provide training and guidance to Sales, Account Management, brokers, and internal stakeholders on onboarding requirements, documentation standards, workflow expectations, and implementation readiness best practices.
• Support revenue activation and new business growth by improving process visibility, reducing
implementation friction, and helping ensure new groups move from sold opportunity to operational setup efficiently and accurately.
Other
• Utilize all capabilities to satisfy one mission - to enhance the competitiveness and profitability ofour members. This job exists to serve directly (or indirectly) to someone in the fresh produce
industry. Do everything possible to help members succeed by being curious and striving to
understand what others are trying to achieve, planning and executing work in a helpful and
collaborative manner, being willing to adjust efforts to ensure that work and attitude are helpful to others, being self-accountable, creating positive impact, and being diligent in delivering results.
• Maintain internet speed of at least 40 MB download and 10 MB upload and router with
wired Ethernet.
• Maintain a HIPAA compliant workstation and utilize appropriate security techniques to ensure
HIPAA required protection of all confidential/protected client data.
• Maintain and service safety equipment (e.g., smoke detector, fire extinguisher, first aid kit).
• All other duties as assigned.