Senior Pharmacy Network Configuration Analyst

📋 Description

• Serve as primary support for pharmacy network/pricing config and Darwin logic.
• Configure and maintain pricing logic for accurate claims.
• Support configuration changes across network participation and pricing.
• Perform unit testing to validate adjudication outcomes.
• Conduct QC/QA reviews to ensure accuracy in configuration.
• Participate in UAT testing for product enhancements.

🎯 Requirements

• Associate or bachelor’s degree (or equivalent work experience).
• 6+ years in PBM Pharmacy Network & Pricing configuration.
• 2+ years SQL and Excel to validate network participation and pricing outcomes.
• Strong analytical skills to identify issues and drive actions.
• Collaborate effectively across technical and operational teams.
• Excellent oral and written communication skills.

🎁 Benefits

• Flexible hybrid work model with on-site days (Puerto Rico location).
• On-call hours including evenings, weekends, holidays (where applicable).
• Documentation and training resources to support onboarding.