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Medical, Dental, Vision, Life, Retirement, PTO
Posted 24 days ago
Job description
The Operations Analyst is responsible for the implementation and support and ongoing maintenance of client and third-party administrator (TPA) electronic data interchange (EDI) processing. The analyst works in operations and utilizes systems and applications for loading batch files, monitoring automated jobs, identifying file/data issues and resolving data exceptions. These processes keep medical coverage eligibility, member demographics, and claim/deductible balance accumulators in sync between VytlOne's PBM platform and our client's systems. Reporting to the Sr. Manager of Client Integration, the Operations Analyst will meet all service standards to ensure client satisfaction.
Who We Are
VytlOne is the nation's only independent, fully integrated total pharmacy solutions partner. We lead with integrity, offering mission-driven hospitals, health systems, health centers, and employer partners a smarter way to unlock revenue, growth, and better outcomes. Our innovative model combines customized pharmacy management, 340B program expertise, specialty pharmacy, and PBA/PBM solutions-delivering excellence through tailored strategies and collaborative partnerships. At VytlOne, we're not just transforming pharmacy-we're making a purposeful impact on the communities we serve.
Why Choose a Career at VytlOne?
At VytlOne, our purpose is at the heart of everything we do. People join us not just for a job, but to be part of something bigger-where their work truly matters. We foster a culture of authenticity, where you're encouraged to be yourself and a place to grow, collaborate and make an real difference. With over 1,600 passionate professionals across nearly every U.S. state, we operate as One Team, united by a bold mission and a spirit of innovation. Here, you'll find a place where your ideas are heard, your contributions are valued, and your career can thrive.
Position Location
This position is a remote based position within the Contintenal US.
Responsibilities- Process and support daily/weekly client batch file updates working directly with account managers, implementation teams and clients.
- Conduct member and file research, file processing, manual updates, data analysis, troubleshoot and resolve integration and data quality issues.
- Demonstrate knowledge of VytlOne's PBM platform, application, file integration functions/standards and client specific configurations.
- Demonstrate knowledge of pharmacy benefit administration, coverage eligibility, claim/deductible accumulators, and setup/configuration within VytlOne's systems.
- Handle routine work stream assignments and ensure quality, service levels, productivity and customer standards are consistently met.
- Comply with VytlOne's Ethical Business Conduct policy and VytlOne's Compliance Program.
- Complete required training, as assigned, within the established timeframes.
- Must demonstrate resilience and professionalism when handling complex, timesensitive responsibilities.
- Promote teamwork and best practices
- Maintain regular attendance in accordance with established policies.
- Perform other job-related duties as assigned.
Education:Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â Â
- High School Diploma/G.E.D. required. Associate's degree or equivalent combination of education and experience
2+ years of progressive experience in:
- PBM operations
- Claims processing
- Eligibility / accumulator processing
- Client integrations
- Health plan or TPA operations
- Data operations / reporting
Experience: Proven analytical, communication and organizational skills.
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Knowledge, Skills, and Abilities:
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- 2+ years of experience as an operations analyst and/or relevant pharmacy benefit management (PBM) experience
- Strong organization skills with the ability to multi-task
- Excellent verbal and written communication skills
- Advanced knowledge of personal computers, including Windows Operating Systems, MS Office (Excel, MS Access, Word, Outlook)
- Capable of learning new applications/processes supporting client operations for pharmacy benefit management (PBM) systems
- Possess analytical aptitude and problem solving skills
- A desire to develop processes and tools to more effectively manage operational tasks
- Ability to research issues and collaborate with internal/external partners though resolution
- Ability to effectively collect and document customer requirements and knowledge share
- Knowledge of electronic file exchange (EDI) files
WE OFFER, At VytlOne we offer a diverse and inclusive work culture that supports a flexible work model in a collaborative, innovative team-oriented environment.
- You'll work with a mission-driven organization focused on improving healthcare outcomes
- Enjoy competitive compensation, a comprehensive health benefits package, and a supportive team environment including:
- Comprehensive mental health and wellbeing resources
- Nationwide Blue Cross Blue Shield PPO with employee-friendly plan design, including a $850 individual annual medical deductible and $25 office visit copays, with low biweekly premiums
- Company-paid basic life/AD&D, short-term and long-term disability insurance
- Rx, dental, vision, other voluntary benefits, and FSA
- Employer-matched 401k Plan
- Industry-leading PTO plan
- And more!
Join us and help build the future of pharmacy care - better outcomes, stronger margins, and healthier communities.
FOR MORE INFORMATION:
VytlOne Website VytlOne LinkedIn
VytlOne (formerly Maxor) is an EOE, including disability/vets
Employment Type: OTHER