PBM Analyst

We are looking for an experienced PBM Analyst to support healthcare testing initiatives. This role centers on coordinating and driving claims comparison testing activities, helping teams prepare for increased business demand while maintaining quality and accuracy.

Responsibilities:

• Lead test planning efforts for claims comparison activities, establishing timelines, priorities, and execution steps that support program objectives.

• Coordinate end-to-end testing tasks with internal teams and offshore partners to promote smooth delivery and timely issue resolution.

• Execute and monitor claims validation work, ensuring results are documented clearly and aligned with expected business outcomes.

• Analyze business system behavior and identify discrepancies, defects, or process gaps that may affect claims administration performance.

• Partner with stakeholders and test leadership to track progress, communicate risks, and recommend practical solutions during the testing cycle.

• Support testing related to organizational growth initiatives by helping prepare scenarios, data needs, and execution readiness.

• Contribute to reporting and documentation that summarizes findings, compares outcomes, and supports decision-making across the project team.

Qualifications:

• Experience working as a Business Analyst or Business Systems Analyst in a testing-focused environment.

• Hands-on knowledge of claims administration processes within healthcare or closely related industries.

• Familiarity with claims comparison, test planning, and structured execution methods across multiple workstreams.

• Ability to collaborate effectively with distributed teams, including offshore resources and cross-functional business partners.

• Understanding of healthcare-related platforms or programs such as TRICARE, NIS, or similar business systems.

• Strong analytical and documentation skills, with the ability to translate findings into clear business recommendations.

• Comfortable working a Monday through Friday day-shift schedule based on manager direction and work location needs.

• Must have RxClaim experience

• Benefits knowledge

Compensation

About Us

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