Department

Job Title

Capital Rx is redefining the way prescriptions are priced and administered in the U.S. Capital Rx unlocks the pharmacy supply chain and reduces prescription costs for employer groups. By establishing a competitive marketplace for drug pricing, Capital Rx focuses its resources on deploying actionable strategies that improve plan performance and patient outcomes. The company's commitment to innovation, technology, and service is why Capital Rx is the fastest-growing pharmacy benefit manager in America.

Finance

Analyst, Pharmacy Financial Operations

Location: Remote (For Non-Local) or Hybrid (Local to NYC area)

Position Summary:

The Analyst, Pharmacy Financial Operations position is a hands-on position responsible for managing the day-to-day operations and activities of the finance team. The Analyst, Pharmacy Financial Operations should be highly motivated, have a positive team attitude, and support the overall organization.

Position Responsibilities:

• Learn entire pharmacy payment process to support team where needed
• Audit vendors within the ERP system for credentials and to ensure accurate vendor setup
• Manage SFTP delivery mapping for accurate transmittal of 835 remittance files
• Assist in financial audits and provide documentation as needed
• Reconcile claims data to ensure all submitted claims are captured within the pharmacy payment process and escalate as appropriate for discrepancies
• Participate in the development and implementation of financial policies and procedures
• Stay up to date with industry standards and compliance requirements
• Write basic SQL queries to retrieve specific Pharmacy files from the data warehouse as needed
• Respond to internal and external inquiries regarding payment data, providing clear and actionable insights
• Other responsibilities as assigned
• Responsible for adherence to the Capital Rx Code of Conduct including reporting of noncompliance

Minimum Qualifications:

• Bachelor’s degree in accounting, Finance, Data science or related field. (In lieu of a degree, equivalent relevant work experience may be considered.)
• 2+ years of experience in PBM with a focus on claims, payments, and remittances
• Foundational knowledge of data tables and SQL
• Strong analytical and problem-solving skills
• Proficiency in Microsoft Excel and financial software
• Excellent communication and interpersonal skills
• Detail oriented with a high level of accuracy
• Ability to work collaboratively in a team and independently
• Knowledge of healthcare compliance regulations is a plus

Nice to have: Experience with Sage software for managing payment processes and financial reconciliations.

Nothing in this position description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.

About Capital Rx

Capital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advancing our nation’s electronic healthcare infrastructure to improve drug price visibility and patient outcomes. As a Certified B Corp™, Capital Rx is executing its mission through the deployment of JUDI®, the company’s cloud-native enterprise health platform, and a Single-Ledger Model™, which increases visibility and reduces variability in drug prices. JUDI connects every aspect of the pharmacy ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of pharmacy benefits and rebuilding trust in healthcare.

Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

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