Data Exchange Analyst - PBM Claims Ops (Hybrid)

Judi Health, LLC; Colorado; Hybrid; USD 89,000 - 111,000; Full time

Job summary

Judi Health is seeking a Data Exchange Analyst to ensure accuracy and reliability of data feeds for pharmacy benefit services. You’ll manage outbound data feeds, assist with client connectivity, and support manual claims activities across internal and external teams.

The role requires strong PBM data knowledge, analytical skills, and effective cross‑functional communication. Hybrid work setup in NYC, Denver, and Charlotte supports collaboration and client success.

Qualifications

• Bachelor’s degree required.
• 1+ years of experience in PBM, healthcare data operations, or IT integration roles.
• Strong understanding of PBM data (eligibility, claims, accumulators, formulary, network) and file layouts.
• Strong analytical and root‑cause problem‑solving skills.
• Proficiency in SQL, Excel, and other data manipulation tools preferred.
• Strong communication skills with the ability to collaborate across technical and business teams.
• Detail‑oriented, self‑motivated, and able to manage multiple priorities in a fast‑paced environment.
• Experience working with data feeds, EDI, or system integrations strongly preferred.

Responsibilities

• Develop, validate, and maintain outbound data feeds (claims, formulary, network, eligibility) to ensure accuracy and alignment with JUDI Rx standards.
• Assist in setting up and testing data connectivity for new and existing clients.
• Support manual claims processing activities, including error resolution and specialized claim scenarios, as directed by the Data Exchange leadership team.
• Execute and support historical data loads and related data preparation tasks.
• Investigate, troubleshoot, and resolve data transfer and loading issues, partnering with internal teams and external integration partners.
• Monitor system status, dashboards, and data movement to detect anomalies or trends that may impact data quality or timeliness.
• Ensure all issues are resolved in accordance with established procedures, quality standards, and defined SLAs.

Skills

Data analysis

SQL

Excel

Healthcare data

Communication

Root-cause analysis

Education

Bachelor’s degree

Tools

EDI

ETL tools

Job description

Judi Health is seeking a Data Exchange Analyst to ensure accuracy and reliability of data feeds for pharmacy benefit services. You’ll manage outbound data feeds, assist with client connectivity, and support manual claims activities across internal and external teams.

The role requires strong PBM data knowledge, analytical skills, and effective cross‑functional communication. Hybrid work setup in NYC, Denver, and Charlotte supports collaboration and client success.