Structure Analyst

Structure Analyst

The Structure Analyst is a highly detailed and technologically skilled professional supporting new client structure implementations or existing client structure changes. They will ensure structure is accurately and timely configured in accordance with the vendor requirements. The Structure Analyst will act as the liaison between internal departments to accomplish critical steps in the implementation and benefit change processes. This individual will utilize technical knowledge to propose and build client structure and query internal systems for auditing to ensure data quality. This role is ultimately responsible for the on-time and accurate internal structure setup of every client request.

Job Responsibilities Include:

• Participate in multiple client projects simultaneously while ensuring all role deliverables are accomplished on time and accurately documented
• Serves as the structure configuration expert on the following projects: new client implementations, medical vendor changes, eligibility changes, TPA changes, PBM to PBM transitions, and various benefit change requests
• Ability to dissect external structure from various vendors, build structure internally to ensure data points match between all parties
• Able to configure structure import application, trouble shoot and successfully import data into system platform
• Own the ESI AGL process, analyze data regarding file and troubleshoot issues
• Ensure that structure is configured to support eligibility, accumulations, and special configurations
• Attends internal/external calls as needed to provide support from a structure perspective
• Serve as a technical expert in various EDI file types to file specifications to troubleshoot errors. i.e. fixed length, 834, delimited files
• Work with internal/external teams to successfully execute the assigned tasks (Benefit Design, Client Onboarding, Benefit Configuration and Quality, Data Operations)
• Track and log defined tasks and deliverables within Clarizen
• Completes work in production-based environment that is measured against timeliness and accuracy
• Meet KPI goals as defined by Operations leadership and department

Required Skills/Experience Include:

• Bachelor’s degree or 4 years of experience
• Proven success in a technical role where thoroughness and detail were critical measures of success
• Employee benefits experience required, pharmacy specific experience preferred
• Advanced Microsoft Excel knowledge required
• Some knowledge of MySQL preferred
• Working knowledge of EDI files with strong preference to 834 experience
• Proven ability to complete highly detailed work with an incredible level of accuracy
• Thorough attention to detail and critical thinking imperative
• Process minded individual who understands the importance of following a consistent process to maximize efficiency & quality
• Ability to handle multiple requests with competing priorities
• Strong written, verbal and presentation skills; able to communicate technical concepts to non-technical personnel