Pharmacy Operations Analyst

Job overview

The Pharmacy Operations Analyst role is hybrid in Birmingham, AL, with regular onsite work at the VIVA HEALTH corporate office and some work-from-home opportunities. Compensation is not specified. VIVA HEALTH is a health maintenance organization providing accessible health care and partnering with members in their healthcare journeys. The analyst monitors pharmacy benefit administration for Commercial and Medicare lines of business, working with pharmacy benefit managers and the Operations team to resolve claims issues and escalations. The work supports accurate claims payment, member experience, reporting, and regulatory compliance.

What you'll do

• Monitor PBM operations, claims issues, eligibility files, accumulation files, and support tickets
• prepare required pharmacy reporting
• create operational dashboards and monitor performance indicators
• track member experience metrics
• collaborate on benefit administration and strategic initiatives
• support escalated member and provider inquiries
• maintain process documentation
• participate in audits and corrective-action monitoring.

What we're looking for

Skills & competencies

pharmacy operations analyst

hybrid

birmingham al

triton health systems

viva health

pharmacy benefits

pbm operations

claims monitoring

commercial and medicare

regulatory compliance

member and provider escalations

Work arrangement

• Weekend coverage required

Benefits & perks

• Health, vision, and dental coverage
• 401(k) with company match and immediate vesting
• paid time off
• paid holidays
• tuition assistance
• flexible spending and healthcare reimbursement accounts
• paid parental leave
• community service time off
• life and disability coverage
• wellness and employee assistance programs
• training and development.

Why this role

Requires a bachelor’s degree or equivalent experience and 5–7 years of experience with a health plan, Part D, pharmaceutical business or industry, or PBM; PBM or pharmacy claims experience preferred.

About the employer

Triton Health Systems is hiring for this role. Industry: Pharmacy Benefit Management and Other Third Party Administration of Insurance and Pension Funds. Sector: 52.