Data Exchange Analyst — PBM Data & Integrations

Capital Rx; Denver (CO); Hybrid; USD 89,000 - 111,000; Full time

Job summary

J Judi Health is seeking a Data Exchange Analyst to ensure accuracy and reliability of data feeds supporting pharmacy benefit services. The role involves outbound data feeds for claims, formulary, network, and eligibility, plus testing data connectivity for clients.

The analyst will work with internal teams to troubleshoot data transfer issues, monitor data movement, and maintain data quality with adherence to HIPAA and regulatory standards. Hybrid work model across NYC, Denver, and Charlotte.

Qualifications

• Bachelor's degree required.
• 1+ years in PBM, healthcare data ops, or IT integration.
• Strong PBM data knowledge (eligibility, claims, formulary).
• Proficiency in SQL and Excel; able to work with data feeds and integrations.

Responsibilities

• Develop, validate, and maintain outbound data feeds (claims, formulary, network, eligibility).
• 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.
• Execute and support historical data loads and related data preparation tasks.
• Investigate, troubleshoot, and resolve data transfer and loading issues; partner with internal and external teams.
• Monitor dashboards and data movement to detect anomalies and ensure data quality.
• Collaborate with Client Ops, Implementation, Product, and Development teams for onboarding and migrations.
• Translate business needs into data requirements or configuration updates; escalate risks as needed.
• Create and update process documentation, SOPs, and configuration guidelines.
• Maintain awareness of Medicare/Medicaid/state regulatory requirements and HIPAA compliance.

Skills

Analytical thinking

Communication

Problem-solving

Attention to detail

Education

Bachelor's degree

Tools

SQL

Excel

EDI

Job description

J Judi Health is seeking a Data Exchange Analyst to ensure accuracy and reliability of data feeds supporting pharmacy benefit services. The role involves outbound data feeds for claims, formulary, network, and eligibility, plus testing data connectivity for clients.

The analyst will work with internal teams to troubleshoot data transfer issues, monitor data movement, and maintain data quality with adherence to HIPAA and regulatory standards. Hybrid work model across NYC, Denver, and Charlotte.