PBM Data Operations Specialist

Rightway; United States; On-site; USD 65,000 - 85,000; Full time

Job summary

Rightway is seeking a PBM Operations Associate to support day-to-day eligibility, accumulator, and claims extract data feeds within the Data Operations team. This role coordinates with engineering, client success, implementations, and benefit administration to ensure timely and accurate data delivery.

Ideal candidates have 2–4 years in healthcare operations or related data roles, strong analytical skills, and proficiency with Excel.

Qualifications

• Bachelor's degree preferred. Relevant experience considered for exceptional candidates.
• 2-4 years of experience in healthcare operations, PBM, health plan, or data/eligibility operations; entry-level candidates with strong analytical skills are encouraged to apply.
• Detail-oriented, organized, strong sense of ownership, ability to work in a fast-paced environment with shifting priorities.

Responsibilities

• Support the execution of eligibility and accumulator file feeds and interfaces, from implementation through ongoing operations and maintenance.
• Support claims extract file feeds, helping ensure data is accurate, complete, and delivered to external stakeholders on schedule.
• Serve as a day-to-day resource for eligibility, accumulator, and claims extract data needs.
• Collaborate with engineering, client success, implementations, benefit administration, and other internal stakeholders to ensure eligibility, accumulator, and claims extract functions operate in accordance with requirements.
• Monitor downstream vendor feeds and third-party integrations to help ensure deliverables are met on time; elevate and assist in troubleshooting issues as they arise.
• Perform research and support troubleshooting of day-to-day inquiries or issues related to eligibility, accumulators, and claims extract/data feeds.
• Maintain accurate, up-to-date documentation of eligibility, accumulator, and claims extract processes and internal controls.
• Additional responsibilities may be assigned as business needs evolve.

Skills

Healthcare operations

PBM

Data/eligibility operations

Excel

Education

Bachelor's degree

Job description

Rightway is seeking a PBM Operations Associate to support day-to-day eligibility, accumulator, and claims extract data feeds within the Data Operations team. This role coordinates with engineering, client success, implementations, and benefit administration to ensure timely and accurate data delivery.

Ideal candidates have 2–4 years in healthcare operations or related data roles, strong analytical skills, and proficiency with Excel.