abarca Remote Full-time 2024-06-27

What you’ll do

In a few words…

Abarca is igniting a revolution in healthcare.  We built our company on the belief that with smarter technology we are redefining pharmacy benefits, but this is just the beginning…

Providing high quality services to clients and beneficiaries is at the core of what we do every day! The Pharmacy Benefits Management Operations & Services team is the very heart of Abarca and meets that standard by running services from MTM, price eligibility, configurations, and beneficiary services to government services and beyond. The Client Data Exchange team handles the client inbound and outbound loads and extracts for data such as Eligibility, Accumulators, Prior Authorizations and Claims.   

Our Client Data Exchange Manager is the lead subject matter expert in all data-related things: file layouts, mapping, logic, implementation, and beyond. They stay at the forefront of relationship building with clients to ensure that all technical needs are met from their side and from Abarca’s internal systems to ensure smooth passage of data back and forth between systems. Their tasks include troubleshooting issues and developing solutions to client-specific needs (via operational design or documentation process flows, etc.). It’ll be important that they partner up with other Pharmacy Benefits Management Operations colleagues and Data Management to ensure all requirements are met and impacts or risks mitigated.

 The fundamentals for the job…

  • Be a data exchange subject matter expert for clients across the organization.
  • Client specific data exchange technical guru that is their go-to for technical business needs. 
  • Know the client – file layouts, logic, and build relationships with client counterparts.
  • Consult with clients to match technology solutions to their data-exchange business needs. 
  • Be the first level of support for data exchange questions or issues.
  • Document requirements and write detailed client-specific user needs required for operations.  
  • Ensure implementation of proper controls around data exchange.
  • Maintain an awareness of schedules and SLAs on data exchange files and oversee their compliance, proactively working with the teams in addressing, as well as communicating to clients.
  • Work with all product and development teams to enhance or fix technical client requests. 
  • Analyze client data through queries and other mechanisms to research and identify client-specific solutions.
  • Perform multiple types of analysis to include system changes, enhancements gaps, impact, and risks for the client. 
  • Document process flows, reports, user stories, etc. 
  • Work with clients to communicate changes and coordinate training when applicable.
  • Work with product owners and other areas to manage and prioritize client-specific requests to ensure accurate expectations of delivery. 

What we expect of you

The bold requirements…

  • Bachelor’s degree (In lieu of a degree, equivalent relevant work experience may be considered.)
  • 5+ years of experience with PBM or health plan data exchange (EDI/ETL) functions.
  • Experience developing SQL queries.
  • Experience related to relational database architecture and data standards.
  • Experience working beyond standard business hours when required by deadlines and deliverables.
  • Excellent oral and written communication skills. 
  • We are proud to offer a flexible hybrid work model which will require certain on-site work days (Puerto Rico Location Only)

Physical requirements…

  • Must be able to access and navigate each department at the organization’s facilities.
  • Sedentary work that primarily involves sitting/standing.

At Abarca we value and celebrate diversity. Diversity, equity, inclusion, and belonging are guiding principles of Abarca and ensure Abarca’s workforce reflects the communities it serves.  We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state, or local laws.

Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify.  “Applicant must be a United States’ citizen. Abarca Health LLC does not sponsor employment visas at this time”

The above description is not intended to limit the scope of the job or to exclude other duties not mentioned. It is not a final set of specifications for the position. It’s simply meant to give readers an idea of what the role entails.