Location: Hybrid - 3 days in office (NYC, Denver or Charlotte)

Position Summary:

This Senior Analyst role is a critical position for Client Financial Operations focusing on the support and administration of invoicing related to areas of business outside of core PBM and PBA services, in particular EGWP. This role will be an instrumental player in developing invoicing processes for other new programs and also drive process improvement within existing non-core services. The individual must have a strong financial background in PBM and premium billing and be comfortable working with Excel and SQL formulas to efficiently run processes.

Position Responsibilities:

• Own and oversee billing operations for non-core programs, including EGWP, by interpreting complex, multi-year contracts, client program requirements, service volumes, fee structures, and financial data to determine appropriate billing approaches.
• Independently evaluate incomplete, conflicting, or unusual billing information; compare alternative courses of action; resolve material issues within established authority; and escalate matters requiring broader approval with a recommended solution.
• Interpret contract terms, and client-specific arrangements to identify billable items, establish appropriate billing mechanisms, and advise internal partners on financial and operational implications.
• Design, implement, and refine invoicing processes, controls, schedules, and operating practices for new and existing programs, coordinate with technology teams when standard procedures do not cover contractual requirements.
• Analyze data from financial, adjudication, membership, and other operational systems to assess billing accuracy, identify trends and financial exposure, determine root causes, and recommend corrective or preventive action.
• Direct invoice preparation, reconciliation, and issuance in accordance with contractual requirements.
• Lead reconciliations across ERP, adjudication, and related platforms; assess the significance of variances; determine appropriate resolution; and coordinate implementation with Finance, Client Services, Operations, and other stakeholders.
• Evaluate existing processes and controls, prioritize improvement opportunities, and use Excel, SQL, or other analytical tools to develop automation and redesign solutions that improve accuracy, scalability, and financial governance.
• Develop and maintain billing policies, procedures, decision criteria, and supporting documentation; recommend changes to operating practices and help implement approved improvements across affected business areas.
• Lead audit and compliance support for assigned programs.

Required Qualifications:

• Undergraduate bachelor’s degree in Business, Finance, or quantitative field
• 5+ years of related experience in finance, data analysis, or accounting
• Experience specific to EGWP Premium invoicing
• Strong Excel and SQL Skills
• Ability to challenge and improve existing processes through automation and redesign
• Motivated team player with the ability to work in a fast-paced, forward-moving environment
• Attention to detail & commitment to delivering high quality work
• Passion for healthcare and for driving lasting change in pharmacy benefits
• Ability to define problems, collect data, establish facts, solve problems, make recommendations, anddraw valid conclusions in a timely and accurate manner
• PBM experience preferred