Benefit Analyst III

🔥 6 hours ago

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WellDyne

WebsiteLinkedInAll Job Openings

501 - 1000 employees

Founded 1990

🏥 Healthcare

💊 Pharmaceuticals

⚕️ Healthcare Insurance

Healthcare • Pharmaceuticals • Healthcare Insurance

WellDyne is a pharmacy benefit management (PBM) company that provides specialty pharmacy services, prescription discount solutions, utilization management, mail-order and central fill pharmacy operations, and outsourced pharmacy solutions. The company emphasizes clinical programs, adherence initiatives, data analytics, and personalized engagement to reduce drug costs and improve outcomes, particularly for high-cost specialty medications. With about 25 years of experience and locations in Lakeland, FL and Centennial, CO, WellDyne positions itself as an alternative to traditional PBM models by offering flexible plan design, dedicated account management, and industry-focused clinical expertise.

📋 Description

• Provides client satisfaction through accurate benefit configuration design and set up, including consultation and collaboration with external clients, brokers and internal business partners • Plan maintenance and benefit change requests for existing clients, including updates annually to member cost share and accumulators • Manages the pre-assessment of benefit change requests by performing research to ensure plan configuration will meet client specifications, providing options for meeting the client intent • Utilize the RxClaim operating system to design, build and maintain client plans and components • End-to-end testing and validation of plans to ensure plan benefits meet client specifications • Ability to determine and prioritize client needs to ensure all change requests meet client deadlines • Research and provide feedback for claim-related inquiries • Participate in external auditor reviews, including claim research • Training current team members and any new hires • Ability to work additional hours as workload dictates • Additional duties as assigned

🎯 Requirements

• Bachelor’s degree or equivalent of education and experience • Proficiency in RxClaim adjudication platform, including experience in PBM benefit design • Ability to work in a fast-paced environment with minimal instruction and a high degree of accuracy and attention to detail • Strong verbal and written communication skills including presentation skills and client relationship management • Sets priorities and manages workflow to ensure efficient, timely and accurate deliverables • Ability to manage and negotiate multiple priorities and deadlines • Maintain a cordial and effective relationship with clients and co-workers and work in a team environment • Strong Analytical skills

🏖️ Benefits

• EOE M/F/D/V – WellDyne and HealthDyne are equal opportunity employer and prohibits discrimination of any kind • Health insurance • 401(k) matching • Flexible work hours • Paid time off • Remote work options