Teams at AffirmedRx, PBC

Leads a specialized data operations team supporting PBM client eligibility and accumulator data. Owns file layouts, data mapping, SFTP transmissions, coding automations, monitoring, change control, and data integrity. Applies hands-on claims adjudication expertise to troubleshoot issues and support client onboarding and escalations. Serves as Scrum Master, manages team performance, coordinates cross-functional priorities, and improves operational processes. Requires direct client communication and 10%–20% travel.

Serves as the liaison between Data Operations and business teams by receiving, documenting, triaging, and analyzing file-related data issues. Determines impact and severity, validates root causes with technical teams, maintains an issue dashboard, communicates proactive status updates, documents resolutions, and identifies recurring problems for process improvement. Requires strong analytical, organizational, and communication skills, with healthcare or pharmacy benefit management experience preferred.

Develops and maintains client eligibility and accumulator files for pharmacy benefit management clients. Applies deep PBM claims adjudication expertise, NCPDP standards, and benefit design knowledge to file specifications, testing, validation, and discrepancy resolution. Builds coding automations, manages SFTP connections, troubleshoots transmission issues, and supports change control while ensuring accurate, secure member and client data.