Pharmacy Operations Analyst - Hybrid (PBM & Benefits)

Viva-Health; Birmingham (AL); Hybrid; USD 65,000 - 95,000; Full time

Benefits offered by this job

Health Coverage

401(k) Plan

Paid Time Off

Holidays & Floating Holiday

Tuition Assistance

Flexible Spending Accounts

Wellness Program

Training & Development

On-site office & collaboration

Job summary

VIVA HEALTH in Birmingham, AL is seeking a Pharmacy Operations Analyst to manage daily PBM-related tasks, monitor claims, and ensure compliance with pharmacy regulations. You will collaborate with PBMs to maintain benefits and resolve payment issues.

The role supports audit activities, generates routine dashboards, tracks eligibility and performance metrics, and communicates findings to management. A bachelor's degree and 5-7 years in health plan or PBM workflows are required.

Qualifications

• Bachelor's degree or equivalent experience required.
• 5–7 years with a Health Plan or PBM experience.
• Strong communication and analytics skills.
• Proficient in Microsoft Office; Power Query experience preferred.

Responsibilities

• Oversee daily PBM monitoring and claims issue tracking.
• Coordinate with PBMs to update benefits and research payment anomalies.
• Maintain compliance with pharmacy regulations and PDE/FIR reporting.
• Create and review operational dashboards to measure KPIs.
• Assist with audits and resolution of member/provider escalations.

Skills

Interpersonal skills

Critical thinking

Public speaking

Analytical abilities

Power Query

Education

Bachelor's degree or equivalent experience

Tools

Access

Word

Excel

PowerPoint

Job description

VIVA HEALTH in Birmingham, AL is seeking a Pharmacy Operations Analyst to manage daily PBM-related tasks, monitor claims, and ensure compliance with pharmacy regulations. You will collaborate with PBMs to maintain benefits and resolve payment issues.

The role supports audit activities, generates routine dashboards, tracks eligibility and performance metrics, and communicates findings to management. A bachelor's degree and 5-7 years in health plan or PBM workflows are required.