Network Analyst
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Job Description
Network Analyst configuring pharmacy pricing, reimbursement, and benefit plans for EmpiRx Health, a clinically driven pharmacy benefits management company. Supporting implementations, QA, claims analysis, and operational documentation.
Responsibilities:
- Implement assigned benefit plan, pricing, network, and reimbursement configurations
- Complete manual pricing changes, MAC updates, pricing table updates, and related operational tasks
- Validate pricing setup, reimbursement logic, and configuration outputs
- Research pricing or configuration discrepancies, document findings, and escalate risks or questions
- Support ongoing maintenance of client pricing, network configuration, and operational records
- Support new client implementations, renewals, and plan changes through configuration, pricing, testing, and validation activities
- Follow QA procedures for benefit plan setup, pricing configuration, reimbursement logic, and claim adjudication outcomes
- Document implementation results, testing outcomes, defects, remediation steps, and lessons learned
- Coordinate with Network Operations, Implementation, Client Experience, Product, and other internal teams
- Use Excel and reporting tools to review claims, pricing, utilization, reimbursement, and client performance data
- Perform ad-hoc analysis and investigate pricing, reimbursement, and operational variances
- Prepare summaries of findings, open questions, and recommended next steps
- Create and maintain process documentation, configuration notes, implementation checklists, QA evidence, MAC update templates, and operational records
- Follow established SOPs and contribute process updates
- Communicate status, risks, blockers, and questions to leadership and cross-functional partners
Requirements:
- Bachelor’s degree required or equivalent relevant work experience as determined by HR and business leadership
- 2+ years of experience, preferably in PBM operations, healthcare operations, benefit plan setup, pricing configuration, reimbursement operations, claim adjudication, or a related field
- Experience working with benefit plan, pricing, reimbursement, network, claim, or other operational configuration processes
- Strong attention to detail and ability to complete manual configuration or pricing updates accurately
- Ability to work independently, manage assigned work, follow documented procedures, and escalate questions or risks appropriately
- Intermediate to advanced Microsoft Excel skills, including formulas, lookups, pivot tables, data validation, and large dataset review
- Analytical and mathematical problem-solving skills with the ability to investigate variances, validate outputs, and summarize findings clearly
- Strong written and verbal communication skills, including the ability to document work clearly and explain operational issues to internal stakeholders
Benefits:
- Paid Time Off
- 401(k) program
- Health Insurance including Dental & Vision coverage
- Health Savings Account
- Employee Assistance Program
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