Sr. Analyst, Adjudication

• Bachelor's degree or 6 years' of experience required.

• 5+ years supporting pharmaceutical affordability or claims adjudication programs, with demonstrated experience leading complex technical initiatives.

• Advanced knowledge of pharmaceutical affordability programs and adjudication workflows.
• Strong understanding of solution architecture, business rule interpretation, and client program design needs.
• Knowledge of NCPDP claims processing, transaction analysis, and technical documentation requirements.
• Understanding of governance, compliance expectations, and operational controls supporting affordability programs.

• Advanced analytical, troubleshooting, and root-cause analysis skills.
• Strong technical specification development, implementation validation, and peer review skills.
• Ability to mentor analysts, share knowledge, and support complex adjudication questions.
• Proficiency with Microsoft Office and reporting tools where applicable.
• Expert understanding and ability to navigate adjudicators' claims processing system and other software as necessary.
• Advanced ability to listen actively and effective written and verbal communications skills for conveying findings, issues, and recommendations.
• Understands the need to share only relevant information.
• Ability to adapt to different audiences, ensuring that the message is clearly articulated.

Ability to listen actively and communicate key issues respectfully.

Understand the need to share only relevant information.

Ability to adapt to different audiences, ensuring that the message is clearly articulated.

Anticipate, identify, and address the needs of customers/clients, sometimes before those needs are voiced.

Actively looks for ways to help people; ability to be thoughtful, empathetic to the needs of others.

Is prompt and courteous in ensuring that the customer's immediate needs or complaints are satisfied.

Focuses on improving the level of service provided to external and internal customers.

Utilizes the technical knowledge and abilities required in the specialist and professional job function to accomplish the desired outcomes.

Demonstrates technical proficiency within the scope of responsibilities.

Understands the technical difficulty and complexity of the activity and provides appropriate advice to others.

Ability to improve or redesign processes by utilizing technical solutions.

Ability to comprehend and perform basic arithmetic.

• Occasional travel may be required to company offices, client sites, or external adjudication vendor locations.

• Adhere to all Company Policies, Procedures, and other training consistent with ConnectiveRx's Information Security and Compliance Programs, including but not limited to the following compliances and regulations: SOC1, SOC2, PCI, HIPAA.
• Maintain strict compliance with company and client policies regarding business rules and ethics, as well as applicable local, state and national federal laws.

Compensation & Benefits: This position offers opportunities for a bonus (or commissions), with total compensation varying based on factors such as location, relevant skills, experience, and capabilities.

Employees at ConnectiveRx can access comprehensive benefits, including medical, dental, vision, life, and disability insurance.

The company regularly reviews and updates its health, welfare, and fringe benefit policies to ensure competitive offerings.

Employees may also participate in the company’s 401(k) plan, with employer contributions where applicable.

Time-Off & Holidays: ConnectiveRx provides a flexible paid time off (PTO) policy for exempt employees, covering sick days, personal days, and vacations.

PTO is determined based on an employee’s first year of service.

Employees also receive eight standard company holidays and three floating holidays annually, with prorations applied in the first year.

The company remains committed to providing competitive benefits and reserves the right to modify employee offerings, including PTO, STO, and holiday policies, in accordance with applicable laws and regulations.