AffirmedRx, PBC
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AffirmedRx 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. Join us in improving health care outcomes for all! We promise to do what’s right, always. Position Summary: The Manager, Data Operations is a hands-on technical leader responsible for the accuracy, reliability, and security of AffirmedRx’s client eligibility data, accumulator data, and related file operations. Reporting to the AVP, Information Technology Operations & Security, this role directly manages a small, highly specialized team and owns SFTP setup and management, coding automations, and the change control process governing client data. Deep, direct PBM experience is essential: this person needs to personally understand eligibility files, accumulator logic, and claims adjudication well enough to guide the team, troubleshoot alongside them, and speak credibly with clients. This is a working leadership role that also carries Scrum Master responsibilities for the team, and it requires someone comfortable meeting directly with clients as issues, onboarding, or escalations require. What you will do: Team Leadership and People Management: • Coach and develop team members across disciplines, building a team that combines deep technical expertise with accountability • Stay close enough to the work to catch problems early — personally review file specifications, code, or adjudication logic when something is at risk, not only through status updates • Balance leading the team with doing the work: step in directly on build, troubleshooting, or client issues when the situation calls for it Client Eligibility and Accumulator Data Management: • Own the accuracy, timeliness, and integrity of client eligibility data and accumulator data across all supported clients • Oversee file layouts, data mapping, and ingestion/egestion processes for eligibility and accumulator files • Apply direct PBM claims adjudication knowledge to identify and resolve data issues before they affect client operations File Management, Automation and SFTP Operations: • Own SFTP setup, configuration, and ongoing management for client and vendor file transmissions • Drive coding automations that reduce manual file handling and lower the risk of error • Ensure monitoring and alerting are in place for file transmission failures, and lead resolution when they occur Change Control and Process Governance: • Own the change control process governing changes to client data, file layouts, and related production systems • Ensure changes are properly documented, tested, and approved before moving to production • Continuously improve change control and operational processes based on lessons learned from past issues Agile Delivery and Scrum Master Duties: • Serve as Scrum Master for the team, running sprint planning, daily standups, and retrospectives • Track team velocity and capacity, and proactively remove blockers to keep work moving • Foster a culture of continuous improvement in how the team plans, executes, and delivers work Client and Cross-Functional Communication: • Meet directly with clients as needed to discuss data issues, onboarding, or escalations, serving as a technically credible point of contact • Partner with the AVP, Information Technology Operations & Security and other IT and business leaders on roadmap execution and prioritization • Translate technical data and file issues into terms non-technical clients and stakeholders can understand and act on What you need: • Bachelor’s degree in a related field, or equivalent experience • Required: direct, hands-on PBM experience, including working knowledge of eligibility files, accumulator data, and claims adjudication processes • 5+ years of experience in data operations, file management, or a related PBM/TPA/adjudicator data role • Prior people management experience required and comfortable setting expectations, coaching, and holding a small team accountable • Experience with SFTP setup, configuration, and management for client or vendor file transmissions • Experience with change control processes in a regulated or healthcare data environment • Scrum Master experience, or working knowledge of Scrum/Agile practices with willingness to serve in that role • Hands-on technical fluency — comfortable reviewing SQL, file specifications, or automation code directly, not only through summaries • Excellent communication skills; comfortable meeting directly with clients to discuss data issues, onboarding, or escalations • Strong organizational and prioritization skills, able to manage multiple clients, projects, and team priorities at once • Mission-driven, humble, and supportive; holds high standards while fostering learning rather than blame • Aligns with AffirmedRx values, promoting trust, accountability, and innovation • Willingness to travel (10%-20%) What you get: • To impact industry change in the pharmacy benefits management space, while delivering the highest quality patient outcomes • To work in a culture where people thrive because when OUR team thrives, OUR business thrives • Competitive compensation, including health, dental, vision and other benefits Note: AffirmedRx is committed to providing equal employment opportunities to all employees and applicants for employment. Remote employees are expected to maintain a professional work environment free of distractions to ensure optimal performance and collaboration. Originally posted on Himalayas
Sourced from Himalayas. Confirm the details and apply on the employer's site.
