Client Data Manager (Medicare)

What you’ll do In a nutshell… Abarca is igniting a revolution in healthcare. We built our company on the belief that smarter technology is redefining pharmacy benefits, but this is just the start… We provide high quality services to clients and beneficiaries daily! The Pharmacy Benefits Management Operations & Services team is the heart of Abarca, providing services ranging from Medication Therapy Management (MTM), pricing eligibility, configurations, and beneficiary services to governmental services. The Darwin Claims Operations team manages the verification of all claims, daily configuration setup and maintenance as well as related special projects, issue management, and configuration research. Our Client Data Exchange Manager is the leading expert in all data-related needs: file layouts, logic, control implementation, and more. They forge strong relationships with clients to ensure that all technical needs, from both the client and Abarca’s internal systems, are met to ensure seamless data exchange. Tasks include adapting to client-specific needs, troubleshooting issues, and developing solutions for client-specific user needs (via operational design or documentation process flows). Partnering with other Pharmacy Benefits Management Operations team members and Data Management is important to ensure all requirements are met and potential impacts or risks are mitigated. The basics for the job… - Serve as the data exchange expert for clients across the organization. - Act as the technical guru for client-specific data exchange needs. - Understand the client – file layouts, logic, and build relationships with client counterparts. - Consult with clients to match technology solutions to their data-related business needs. - Serve as the first level of support for data exchange questions or problems. - Document requirements and write detailed client-specific user needs for operations. - Ensure proper controls are implemented around data exchange. - Maintain awareness of schedules and Service Level Agreements (SLAs) on data exchange files and supervise their compliance. - Work with product and development teams to enhance or rectify technical client requests. - Analyze client data through queries and other mechanisms to identify client-specific solutions. - Perform multiple types of analyses including system changes, enhancements gaps, impacts, and risks assessment for the client. - Document process flows, reports, user stories, etc. - Communicate changes to clients and coordinate training when applicable. - Manage and prioritize client-specific requests with product owners and other areas to ensure correct expectations of delivery. What we expect of you The bold requirements… - A Bachelor’s or Master’s Degree in a quantitative or analytical discipline (or equivalent relevant work experience). - 6+ years of work-related experience. - 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 with dashboarding tools or Python. - Willing to work beyond standard business hours when required by deadlines and deliverables. - Excellent verbal and written communication skills. - A flexible hybrid work model requiring 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 mainly involves sitting/standing. At Abarca, we value and celebrate diversity. Our commitment to diversity, equality, inclusion, and belonging guide our hiring practices and reflect the communities we serve. We are proud to be an equal opportunity employer and forbid any discrimination or harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, veteran status, sexual orientation, gender identity or expression, or any other status protected by federal, state, or local laws. Abarca Health LLC is an equal employment opportunity employer and participates in E-Verify. Applicants must be US citizens. We do not sponsor employment visas at this time. The above description does not limit the job's scope or exclude other duties. It is not a final specification for the position, but only gives an idea of what the role entails. #LI-CL1 #LI-REMOTE