PBM Financial Analyst

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development. 

 

Summary

As an PBM Financial Analyst at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges.

Gainwell is looking for an Associate Professional Finance to join the Texas Vendor Pharmacy Modernization (VPM) Team.  As a member of the Team you will be directly involved in the day-to-day pharmacy claims adjudication financial activities, provider recoupments and non-risk payments.

Here are the details on this position.

Your role in our mission

• Perform day-to-day financial activities associated with pharmacy claims adjudication
• Performs pharmacy provider recoupment processes
• Coordinates non-risk payment process involving managed care
• Performs activities involving pharmacy claims payment cycle
• Updates pharmacy claim payment procedures and associated materials, including policies and procedures, desk-level procedures, and manuals

What we're looking for

• Bachelor's degree in business administration, finance, accounting or related field; or equivalent combination of education and experience
• Healthcare claims adjudication and processing experience
• Advanced Microsoft Office, Visio, and Project software skills. Strong analytical and problem-solving skills
• Strong verbal, written, and presentation communication skills
• Strong organization and time management skills
• Ability to manage multiple priorities ensuring deadlines are achieved, while being adaptable to changing priorities

Preferred Skills / Experience

• 3 or more years of PBM finance, accounting, or equivalent experience 
• Experience working with Medicaid/MMIS, pharmacy benefit manager, or related healthcare entity 
• Experience with claims processing and/or financial reporting in a healthcare environment 
• Experience using financial software such as Flexi 

What you should expect in this role

• Remote, work-from-home position from US location
• Hybrid possibility (not required) if selected candidate resides in Austin, TX area.
• Ability to work independently and as part of a team
• Video cameras must be used during all interviews, as well as during the initial week of orientation

#LI-HC1

#LI-Flexi

 

The pay range for this position is $44,500.00 - $63,500.00 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

 

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

 

Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.