Pharmacy Benefits Config Analyst Hybrid

Moda Health; Portland (OR); Hybrid; USD 50,000 - 62,000; Full time

Benefits offered by this job

Medical, Dental, Vision, Pharmacy,Life

401K- Matching

FSA

Employee Assistance Program

PTO and Company Paid Holidays

Job summary

Moda Health in Portland, Oregon seeks a Benefits Configuration Analyst to support benefits setup, claims analysis, auditing, processing, and workflow oversight. You will gather data, interpret results, and regulate processes with guidance on projects and priorities.

This role emphasizes accuracy, confidentiality, and cross-team collaboration in a hybrid work setting. Ideal candidates bring an AA degree, PBM knowledge, and strong analytical skills, with proficiency in Microsoft Office to manage

Qualifications

• AA degree from an accredited college; four years of qualifying experience may substitute.
• Strong analytical abilities with high accuracy and research focus.
• Working knowledge of PBM operations and pharmacy benefits terminology.
• Ability to interpret policies, regulations and contracts related to benefits.
• Proficient with Microsoft Office, especially Word and Excel.
• Excellent communication and ability to maintain confidentiality.

Responsibilities

• Code new plans and changes into PBM databases and perform post-implementation audits.
• Oversee renewal processes and ensure timely coding of new group benefits.
• Perform ongoing coding maintenance and QA checks on plan designs.
• Analyze claims data to support benefits configuration decisions.
• Coordinate with internal and external teams to implement plan changes.
• Maintain documentation for policies, procedures and system configurations.

Skills

Analytical skills

PBM knowledge

Microsoft Office (Word/Excel)

Claims processing

Education

AA degree

CPhT preferred

Tools

PBM systems

Job description

Moda Health in Portland, Oregon seeks a Benefits Configuration Analyst to support benefits setup, claims analysis, auditing, processing, and workflow oversight. You will gather data, interpret results, and regulate processes with guidance on projects and priorities.

This role emphasizes accuracy, confidentiality, and cross-team collaboration in a hybrid work setting. Ideal candidates bring an AA degree, PBM knowledge, and strong analytical skills, with proficiency in Microsoft Office to manage