Product Management Senior Advisor, Claims Transactions and Adjustments - Express Scripts - Hybrid

Description of Position:

The Product Management Senior Advisor is responsible for supporting Claim and Adjustment data that is provided to our clients.

To help educate clients on methods of delivery, interpreting the data and best practices for using the data within their systems.

The position will also support internal stakeholders and account teams as a subject matter expert on claim and adjustment data.

This position will ensure responsibility in establishing a working partnership and process flow between the client, account management, finance and data analytics team(s).

Support on client calls providing overview of the processes, expectations, education and answering client questions as needed.

Position Details:


* Serve as the Regulated Markets business owner for Claim and Adjustment data that is provided to our clients


* Meet with account teams and clients, educating how data claim and adjustment data is provided and how to understand and use the data


* Understanding project changes due to new or changing regulations and the impact to data and files provided internally and to clients


* Establishing a working partnership and process flow between the client, account management and data analytics team(s)


* Responsible for gathering business requirements and define alignment on functional requirements and rules.


* Analyze trends and data to develop recommendations to ensure client needs, compliance metrics, and/or internal support is met


* Ensure internal/external policies and procedures are documented, maintained, and followed


* Understand and use system tools to research and resolve issues and concerns


* Cross-train and support other team initiatives where appropriate


* Exhibit problem solving capabilities in a complex environment


* Participate in cross-functional projects or work teams


* Ability to appropriately interact with clients/account teams including:
+ Communicate information about their area of expertise
+ Meet with clients to educate and also help troubleshoot concerns
+ Manage account team expectations and ensure appropriate follow-up

Qualifications:


* College degree or equivalent experience preferred.


* 5 or more years work experience, preferably in business analysis.


* Regulated Markets experience preferred


* Familiarity with pharmacy adjudication and other PBM operations


* Proficient in collecting and analyzing large data sets


* Strong strategic, analytical, problem solving, and project management skills required


* High attention to detail and proven ability to manage multiple, competing priorities simultaneously.


* Internal and External Customer focused in all activities


* Excels working cross functionally, at all levels of the organization to own, drive, manage and continuously improve the processes, perform root cause analysis, and develop reporting, and communication processes


* K...