The Network Analyst is responsible for executing pharmacy network pricing, implementing plan configurations, and performing quality assurance for commercial business. They also conduct data analysis, research pricing discrepancies, and collaborate with cross-functional teams to ensure operational accuracy.
The Care & Resolution Specialist serves as the primary point of contact for complex member inquiries, ensuring prompt and compassionate resolution of escalated concerns. They act as an administrative liaison between members, pharmacies, and prescribers while managing prescription claims and benefit authorizations.
The PBM Operations Team Lead manages the operational performance, quality, and continuous improvement of pharmacy benefit processes for a designated client book of business. This role leads a multi-disciplinary team to ensure data integrity, timely issue resolution, and operational excellence across PBM systems.
