Capital Rx · 2 hours ago
Analyst, Data Exchange - Eligibility
United States
Full-time
Remote
Entry Level
$85K/yr - $110K/yr
1+ years expJudi Health is an enterprise health technology company focused on providing innovative healthcare solutions. They are seeking an Analyst for Data Exchange - Eligibility to support client implementations, ensure data integrity, and resolve eligibility issues within the pharmacy benefit management sector.
Hospital & Health Care
Responsibilities
Attend new client implementation meetings with external partners to discuss eligibility requirements and protocols
Recommend eligibility file formats to external partners and coordinate receipt and processing of eligibility data
Acting as a healthcare data subject matter expert on Eligibility guidelines and Electronic Data Interchange (EDI) protocols
Serving as a point of coordination for member eligibility issue identification and issue resolution with internal teams and external partners
Identify and triage eligibility issues and support the resolution of all errors related to transferring, loading, and management of eligibility data
Proactively monitoring system status and eligibility data to quickly identify potential abnormalities that might impact quality and accuracy
Ensuring that all issues and errors are resolved using designated operating standards and within defined service levels
Assist with the validation of eligibility data integrity through regular audits and reconciliation processes
Ensure accurate and timely entry of group/plan structure determinations for benefits and enrollment
All employees are responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance
Qualification
Required
Bachelor's degree
1+ years of previous work experience, preferably in PBM, Healthcare, Data Exchange, and Eligibility
Ability to match key PBM concepts and data fields across various systems and file layouts to ensure consistency and accuracy of data transfers
Ability to analyze complex business problems to discover and resolve root causes
Proficiency in SQL, Excel, JSON and other technical data skills preferred
Strong communication skills with the ability to develop effective work relationships with internal and external stakeholders
Self-motivated and detail-oriented problem solver
Ability to handle multiple competing priorities in a dynamic environment and collaborate in a team
Preferred
Proficiency in SQL, Excel, JSON and other technical data skills preferred
Company
Capital Rx
Capital Rx is now Judi Health! Navigate to our new page here: https://www.linkedin.com/company/judi-health
501-1000 employees
H1B Sponsorship
Capital Rx has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (3)
2024 (2)
2023 (1)
2022 (1)
2021 (5)
Funding
Current Stage
Late StageLeadership Team
A. J. Loiacono
CEO
Ryan Kelly
CTO
Recent News
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