Network Analyst

Network Analyst

EmpiRx Health is the leading clinically-driven pharmacy benefits management company. As the pioneer in value-based pharmacy care, EmpiRx Health puts its customers and members first by enabling them to take control of their pharmacy benefits, healthcare outcomes, and financial results. 

We place more emphasis on member care than any other PBM by focusing on health outcomes first. Our pharmacists and clinicians are at the center of everything we do―and our population health solution delivers tailored strategies for our clients. Leveraging our newly launched, AI-powered pharmacy care platform, Clinically™, EmpiRx Health’s pharmacists and client experience teams provide the highest quality pharmacy care to our clients and their members. This enables benefits plan sponsors to keep their members healthy, happy, and productive, while substantially reducing prescription drug spending, which has been on an explosive growth trajectory in recent years.

The Network Analyst is a hands-on operations and configuration role responsible for supporting pharmacy network pricing execution, plan configuration implementation, manual pricing changes, and pricing quality assurance for EmpiRx Health’s commercial book of business. This role requires the ability to work independently, complete assigned implementation and pricing tasks accurately, and research configuration or pricing issues using claims, reimbursement, pricing, and benefit plan data. The Analyst partners with Network Operations leadership and cross-functional teams to support accurate setup, validation, documentation, and ongoing operational execution. This role has no direct people oversight.

Key Responsibilities:

Plan Configuration, Pricing Execution & Manual Updates

• Implement assigned benefit plan, pricing, network, and reimbursement configurations in accordance with approved direction and documented requirements.

• Complete manual pricing changes, MAC updates, pricing table updates, and related operational tasks accurately and within expected timelines.

• Validate pricing setup, reimbursement logic, and configuration outputs to confirm that changes were implemented as intended.

• Research pricing or configuration discrepancies, document findings, and escalate risks or questions to Network Operations leadership when appropriate.

• Support ongoing maintenance of client pricing, network configuration, and related operational records.

Implementation Support & Quality Assurance

• Support new client implementations, renewals, and plan changes by completing assigned configuration, pricing, testing, and validation activities.

• Follow QA procedures to verify benefit plan setup, pricing configuration, reimbursement logic, and claim adjudication outcomes across applicable platforms.

• Document implementation results, testing outcomes, defects, remediation steps, and lessons learned to support repeatable execution.

• Coordinate with Network Operations, Implementation, Client Experience, Product, and other internal teams to resolve assigned implementation or configuration issues.

• Maintain attention to detail and accuracy when working through high-impact pricing and implementation tasks.

Data Analysis, Research & Performance Support

• Use Excel and available reporting tools to review claims, pricing, utilization, reimbursement, and client performance data.

• Perform assigned ad-hoc analysis to help research client performance changes, pricing questions, pharmacy reimbursement issues, or operational variances.

• Apply mathematical and analytical reasoning to validate pricing outputs, compare reimbursement scenarios, and identify potential data or configuration issues.

• Prepare clear summaries of findings, open questions, and recommended next steps for review by Network Operations leadership.

• Develop working knowledge of MAC pricing principles, pharmacy reimbursement concepts, effective rate calculations, and commercial PBM pricing operations.

Documentation, Process Support & Cross-Functional Collaboration

• Create and maintain process documentation, configuration notes, implementation checklists, QA evidence, MAC update templates, and related operational records.

• Follow established SOPs and contribute updates when process gaps, recurring issues, or improvement opportunities are identified.

• Research benefit plan, pricing, configuration, contract, or regulatory questions as assigned and escalate unclear items with supporting detail.

• Work independently while communicating status, risks, blockers, and questions clearly to leadership and cross-functional partners.

• Support a culture of accuracy, accountability, documentation, collaboration, and continuous improvement within Network Operations.

Required Qualifications & Experience:

• Bachelor’s degree required or equivalent relevant work experience as determined by HR and business leadership.

• 2+ years of experience preferably in PBM operations, healthcare operations, benefit plan setup, pricing configuration, reimbursement operations, claim adjudication, or a related field.

• Experience working with benefit plan, pricing, reimbursement, network, claim, or other operational configuration processes.

• Strong attention to detail and ability to complete manual configuration or pricing updates accurately.

• Ability to work independently, manage assigned work, follow documented procedures, and escalate questions or risks appropriately.

• Intermediate to advanced Microsoft Excel skills, including formulas, lookups, pivot tables, data validation, and large dataset review.

• Analytical and mathematical problem-solving skills with the ability to investigate variances, validate outputs, and summarize findings clearly.

• Strong written and verbal communication skills, including the ability to document work clearly and explain operational issues to internal stakeholders.

Preferred Qualifications but Not Required

• PBM, pharmacy network, managed care, healthcare claims, or prescription benefit operations experience.

• Experience setting up or validating benefit plans, pricing configurations, reimbursement logic, or network configurations in a claim adjudication platform.

• Experience completing manual pricing changes, MAC updates, pricing table maintenance, or related operational updates.

• Familiarity with pharmacy reimbursement concepts, MAC pricing, effective rate calculations, AWP-based pricing, dispensing fees, or client guarantee monitoring.

• Experience with reporting or analytics platforms such as Power BI, Tableau, SQL, Databricks, Domo, or similar tools.

• Experience creating process documentation, QA checklists, implementation notes, technical requirements, or operational templates.

Work Environment: Remote 

Benefits And Perks

Subject to program eligibility, this position qualifies for a robust suite of benefits including Paid Time Off, a 401(k) program, Health Insurance including Dental & Vision coverage, Health Savings Account, and an Employee Assistance Program.

EmpiRx Health is an Equal Opportunity Employer 

At EmpiRx Health, we wholeheartedly embrace the power of diversity and the magic of inclusion. The kaleidoscope of unique perspectives, backgrounds, and talents fuels our innovation and sets us apart. We're on a mission to build a team as diverse as the world we serve, where everyone is welcome and celebrated. We're not just breaking down barriers; we're actively erasing them to create an environment where opportunity knows no bounds. In unity, we find our strength and invite individuals from all walks of life to join us in our exhilarating journey to shape a brighter, more inclusive future together.

Note: This job description is a general outline of responsibilities and qualifications for the role. Additional duties may be assigned, and the position may evolve to meet the organization's needs.Top of Form