Hybrid Healthcare Data Exchange Analyst

Capital Rx; Denver (CO); Hybrid; USD 88,000 - 111,000; Full time

Job summary

Judi Health seeks a qualified specialist to coordinate eligibility data across PBM systems, discuss formats with external partners, and ensure accurate data transfers. You will act as a healthcare data SME on eligibility guidelines and EDI protocols, resolving data issues and supporting audits to maintain data integrity.

The role is hybrid with offices in NYC, Denver, and Charlotte, providing opportunities to contribute to client implementations and maintain compliance while collaborating across

Qualifications

• Bachelor's degree required.
• 1+ years of experience in PBM, healthcare, data exchange, or eligibility.
• Ability to map PBM concepts and data fields across systems for consistent data transfers.
• Proficient in SQL, Excel, and JSON.
• Strong communication and collaboration skills.

Responsibilities

• Attend client implementation meetings with external partners to discuss eligibility requirements and protocols.
• Recommend eligibility file formats and coordinate receipt and processing of eligibility data.
• Act as a healthcare data SME on eligibility guidelines and EDI protocols.
• Coordinate eligibility issue identification and resolution with internal teams and external partners.
• Identify and triage eligibility issues; support resolution of data transfer errors.
• Monitor system status and eligibility data to identify anomalies affecting quality.
• Ensure issues are resolved following operating standards and SLAs.
• Assist with validation of eligibility data integrity through audits and reconciliations.
• Ensure accurate entry of group/plan structure determinations for benefits and enrollment.

Skills

SQL

Excel

JSON

Data analysis

Communication

Education

Bachelor's degree

Job description

Judi Health seeks a qualified specialist to coordinate eligibility data across PBM systems, discuss formats with external partners, and ensure accurate data transfers. You will act as a healthcare data SME on eligibility guidelines and EDI protocols, resolving data issues and supporting audits to maintain data integrity.

The role is hybrid with offices in NYC, Denver, and Charlotte, providing opportunities to contribute to client implementations and maintain compliance while collaborating across