Data Integration Analyst

Abarca Health•San Juan, PR

19d•Hybrid

About The Position

As a Data Integration Analyst at Abarca, you are the day-to-day engine of client data operations. You independently monitor inbound and outbound data exchanges, investigate file load issues, and help ensure that client eligibility, accumulator, and claims data flows accurately and on time. The role requires analytical skills and attention to detail to identify root causes, communicate impacts, and drive resolution while developing expertise in PBM data systems and client integrations. The position also supports client implementations, data requests, quality assurance, reconciliation, and improvements to data exchange processes. Work may require availability for a specified time zone or schedule to meet business needs, and may include on-call support during evenings, weekends, or holidays when operational demands require it. Abarca offers a flexible hybrid work model requiring certain on-site workdays for the Puerto Rico location only.

Requirements

Bachelor's or master's degree in a related area; equivalent relevant work experience may be considered in lieu of a degree.
At least 3 years of experience with PBM or health plan data exchange functions (EDI/ETL).
Experience developing SQL queries for data analysis and validation.
Experience related to relational database architecture and data standards.
Solid working knowledge of PBM data domains, including eligibility, accumulators, benefit groups, and claims.
Experience with Darwin or comparable PBM system platforms.
Excellent oral and written communication skills.
Availability to work in a specified time zone or schedule to accommodate client and team business needs.
May need to be available for on-call hours, including evenings, weekends, and holidays, to address emergent issues or provide support when operational demands require it.
Must be able to access and navigate each department at the organization’s facilities.
Work is sedentary and primarily involves sitting or standing.

Nice To Haves

Experience with dashboarding tools or Python for data validation and reconciliation.
Familiarity with healthcare industry data standards and PBM regulatory frameworks, such as Medicare Part D and CMS.

Responsibilities

Assess file load rejects and threshold limit conditions, identify root causes, and independently take action to remediate issues.
Respond to file alerts, such as missing or delayed files, and drive timely remediation.
Monitor and track file processing to ensure adherence to client schedules and service level agreements.
Perform quality assurance reviews of data loads, including reviewing load reports and sampling data, and take corrective action when issues are identified.
Manage accumulator and eligibility review and reconciliation processes to ensure alignment between Abarca and client systems.
Analyze assigned client data requests and provide findings within SLA response timeframes.
Use SQL and other analytical tools to analyze data, respond to client requests, and identify client-specific solutions.
Read and interpret flat-file layouts for eligibility, accumulators, and claims to identify mapping gaps and integration issues.
Ensure adherence to existing data-exchange controls.
Document investigation steps, findings, and resolution actions in ADO, CRM, or Confluence for traceability.
Identify improvements to client data-exchange processes and communicate solutions to technical and non-technical audiences.
Collaborate with internal teams on client implementations, including testing file loads and extracts, reviewing load reports, and sharing results.
Perform additional tasks or special projects as assigned.