Operations Analyst

VytlOne; United States; Remote; USD 70,000 - 90,000; Full time

Job summary

VytlOne is seeking an Operations Analyst to implement, support, and maintain client and TPA EDI processing. The role ensures data parity across the PBM platform and client systems, monitoring jobs and resolving data exceptions. Reporting to the Sr.

Manager of Client Integration, you will meet service standards for client satisfaction. The position is remote within the Continental US, with a focus on PBM operations, eligibility processing and data integrity across healthcare platforms.

Qualifications

• 2+ years of experience in PBM operations or related field.
• Experience with claims processing and eligibility/accumulator processing.
• Experience with client integrations and health plan/TPA operations.
• Strong analytical, written and verbal communication skills.

Responsibilities

• Process and support daily/weekly client batch updates with account managers and clients.
• Research and resolve data issues, troubleshoot integrations and quality problems.
• Demonstrate knowledge of PBM platform, file integration standards and client configurations.
• Maintain data integrity across systems and ensure service levels are met.
• Collaborate with internal/external partners to resolve issues.

Skills

Analytical aptitude

Communication skills

Multi-tasking

MS Office proficiency

PBM/EDI knowledge

Education

High School Diploma/G.E.D.

Associate's degree or equivalent

Tools

Windows OS

MS Office (Excel/Access/Word/Outlook)

Job description

Overview

The Operations Analyst is responsible for the implementation and support and ongoing maintenance of client and third-party administrator (TPA) electronic data interchange (EDI) processing. The analyst works in operations and utilizes systems and applications for loading batch files, monitoring automated jobs, identifying file/data issues and resolving data exceptions. These processes keep medical coverage eligibility, member demographics, and claim/deductible balance accumulators in sync between VytlOne's PBM platform and our client's systems. Reporting to the Sr. Manager of Client Integration, the Operations Analyst will meet all service standards to ensure client satisfaction.

Who We Are

VytlOne is the nation's only independent, fully integrated total pharmacy solutions partner. We lead with integrity, offering mission-driven hospitals, health systems, health centers, and employer partners a smarter way to unlock revenue, growth, and better outcomes. Our innovative model combines customized pharmacy management, 340B program expertise, specialty pharmacy, and PBA/PBM solutions-delivering excellence through tailored strategies and collaborative partnerships. At VytlOne, we're not just transforming pharmacy - we're making a purposeful impact on the communities we serve.

Why Choose a Career at VytlOne?

At VytlOne, our purpose is at the heart of everything we do. People join us not just for a job, but to be part of something bigger, where their work truly matters. We foster a culture of authenticity, where you're encouraged to be yourself and a place to grow, collaborate and make an real difference. With over 1,600 passionate professionals across nearly every U.S. state, we operate as One Team, united by a bold mission and a spirit of innovation. Here, you'll find a place where your ideas are heard, your contributions are valued, and your career can thrive.

Position Location

This position is a remote based position within the Contintenal US.

Responsibilities

• Process and support daily/weekly client batch file updates working directly with account managers, implementation teams and clients.
• Conduct member and file research, file processing, manual updates, data analysis, troubleshoot and resolve integration and data quality issues.
• Demonstrate knowledge of VytlOne's PBM platform, application, file integration functions/standards and client specific configurations.
• Demonstrate knowledge of pharmacy benefit administration, coverage eligibility, claim/deductible accumulators, and setup/configuration within VytlOne's systems.
• Handle routine work stream assignments and ensure quality, service levels, productivity and customer standards are consistently met.
• Comply with VytlOne's Ethical Business Conduct policy and VytlOne's Compliance Program.
• Complete required training, as assigned, within the established timeframes.
• Must demonstrate resilience and professionalism when handling complex, time-sensitive responsibilities.
• Promote teamwork and best practices
• Maintain regular attendance in accordance with established policies.
• Perform other job-related duties as assigned.

Qualifications

Education:

• High School Diploma/G.E.D. required. Associate's degree or equivalent combination of education and experience

2+ years of progressive experience in:

• PBM operations
• Claims processing
• Eligibility / accumulator processing
• Client integrations
• Health plan or TPA operations
• Data operations / reporting

Experience: Proven analytical, communication and organizational skills.

Knowledge, Skills, and Abilities:

• 2+ years of experience as an operations analyst and/or relevant pharmacy benefit management (PBM) experience
• Strong organization skills with the ability to multi-task
• Excellent verbal and written communication skills
• Advanced knowledge of personal computers, including Windows Operating Systems, MS Office (Excel, MS Access, Word, Outlook)
• Capable of learning new applications/processes supporting client operations for pharmacy benefit management (PBM) systems
• Possess analytical aptitude and problem solving skills
• A desire to develop processes and tools to more effectively manage operational tasks
• Ability to research issues and collaborate with internal/external partners through resolution
• Ability to effectively collect and document customer requirements and knowledge share
• Knowledge of electronic file exchange (EDI) files

WE OFFER, At VytlOne we offer a diverse and inclusive work culture that supports a flexible work model in a collaborative, innovative team-oriented environment.

• You’ll work with a mission-driven organization focused on improving healthcare outcomes
  • Enjoy competitive compensation, a comprehensive health benefits package, and a supportive team environment including:
  • Comprehensive mental health and wellbeing resources
  • Nationwide Blue Cross Blue Shield PPO with employee-friendly plan design, including a $850 individual annual medical deductible and $25 office visit copays, with low biweekly premiums
  • Company-paid basic life/AD&D, short-term and long-term disability insurance
  • Rx, dental, vision, other voluntary benefits, and FSA
  • Employer-matched 401k Plan
  • Industry-leading PTO plan
  • And more!

Join us and help build the future of pharmacy care - better outcomes, stronger margins, and healthier communities.

FOR MORE INFORMATION:

VytlOne Website VytlOne LinkedIn

VytlOne (formerly Maxor) is an EOE, including disability/vets