<p><strong>AffirmedRx</strong> is on a mission to improve health care outcomes by bringing clarity, integrity, and trust to pharmacy benefit management. We are committed to making pharmacy benefits easy to understand, straightforward to access and always in the best interest of employers and the lives they impact. We accomplish this by bringing total clarity to business practices, leading with clinical approaches, and utilizing state-of-the-art technology.</p> <p>Join us in improving health care outcomes for all! <strong>We promise to do what’s right, always.</strong></p> <p><strong>Position Summary:</strong></p> <p>The Business Analyst, Data Operations is the primary liaison between the Data Operations team and AffirmedRx’s business-facing teams, particularly Client Management and Patient Care Advocates, and the day-to-day operational contact for the third-party administrators (TPAs) that exchange eligibility and accumulator data with AffirmedRx. Reporting to the Manager, Data Operations, this individual owns the operational health of eligibility and accumulator file exchange: managing SFTP connections and transfers in Couchdrop, building automations that reduce manual file handling, and troubleshooting discrepancies between member claims in the pharmacy claims adjudication platform and the accumulator ledgers maintained by TPAs. When a client manager, patient care advocate, or TPA partner identifies a file or data issue, this person gathers the details, conducts impact analysis to determine scope and severity, drives the issue to resolution, and keeps every involved party informed from the moment it is reported. No one should have to ask for a status update. The role also leads data operations projects from scoping through delivery and identifies, builds, and deploys AI-assisted tools that improve the speed and accuracy of the team’s work. Excellent written and verbal communication skills are essential, since this individual routinely translates between technical data operations work, external partners, and the business teams who depend on it.</p> <p><strong>What you will do:</strong></p> <p><strong>Eligibility and Accumulator File Management (SFTP):</strong></p> <ul> <li>Administer SFTP connections, folder structures, credentials, and user access in Couchdrop for inbound and outbound eligibility and accumulator files across clients and TPA partners</li> <li>Monitor daily file receipt and delivery, confirming files arrive on schedule, in the expected layout, and with record counts consistent with prior cycles</li> <li>Coordinate new SFTP setups and changes for client onboarding and TPA implementations, including connection testing, key and credential exchange, and file naming conventions</li> <li>Maintain an accurate inventory of partner connections, file schedules, and file-handling procedures</li> </ul> <p><strong>SFTP Automation:</strong></p> <ul> <li>Design, build, and maintain automated file workflows, including routing, renaming, archiving, notifications, and handoffs to downstream processing, to reduce manual file handling and human error</li> <li>Build monitoring and alerting for late, missing, duplicate, or malformed files so issues are caught before they affect members</li> <li>Test and document every automation, including failure handling and recovery steps, before it goes into production</li> </ul> <p><strong>Claims and Accumulator Reconciliation:</strong></p> <ul> <li>Troubleshoot accumulator discrepancies by reconciling member claims in the pharmacy claims adjudication platform against TPA and medical carrier accumulator ledgers (deductible and out-of-pocket)</li> <li>Trace claim-level detail (reversals, adjustments, file-cycle timing, and plan-year boundaries) to identify where and why member balances diverge</li> <li>Partner with Data Operations team members (ETL Developer/File Management Analyst, Senior Data Operations Engineer, PBM Claims Adjudication Expert) to validate findings, confirm root cause, and verify corrections are applied on both sides</li> </ul> <p><strong>TPA and Partner Relations:</strong></p> <ul> <li>Serve as the day-to-day operational contact for TPA partners on eligibility and accumulator file exchange</li> <li>Build trusted working relationships with TPA operations and technical contacts, and lead recurring and ad hoc calls to resolve file and data issues</li> <li>Coordinate file specification changes, layout updates, and testing with TPAs, ensuring changes are communicated internally before go-live</li> <li>Track partner-side commitments and follow up until they are met</li> </ul> <p><strong>Issue Intake, Impact Analysis, and Proactive Communication:</strong></p> <ul> <li>Serve as the primary point of contact for client managers and patient care advocates reporting file-related or data issues</li> <li>Gather all relevant details needed to scope each issue (client, file type, affected dates, impacted records, and related context), then log and categorize it to support tracking, prioritization, and reporting</li> <li>Conduct thorough impact analyses to determine which clients, members, or files are affected, and present findings clearly to both technical and non-technical audiences</li> <li>Build and maintain a dashboard or similar tracking tool that serves as the single source of truth on all open issues</li> <li>Provide proactive, regular updates to stakeholders, especially when work begins on an issue and when it is resolved</li> </ul&g