Pharmacy Network Operations Analyst

Pharmacy Data Management, Inc. • Poland, OH

5d • Remote

About The Position

PDMI is looking to add a Pharmacy Network Operations Analyst to our team! This role supports the analysis, maintenance, and ongoing optimization of PDMI’s Pharmacy and Client Networks, contributing to network design, pricing strategies, MAC operations, and issue resolution through detailed data analysis and system updates. Since 1984, PDMI has provided pharmacy data processing and other flexible, scalable solutions to help our clients meet their business objectives. We offer transparent, pass-through pharmacy processing and other services for private label Pharmacy Benefit Managers (PBMs), vertically integrated health plans and hospital systems. In addition to Pharmacy Benefit Administrative Services, we offer 340B Administration, Hospice and Long-Term Care Services.

Requirements

• Bachelor’s degree in Health Administration, Healthcare Analytics, Business, Finance, or a related field or equivalent industry experience required.
• Database development and reporting experience using SQL, TOAD, or similar tools required.
• Strong data analysis and data manipulation skills required; pharmacy data analysis experience preferred.

Nice To Haves

• 3+ years of pharmacy network experience preferred.

Responsibilities

• Acquire and maintain a strong understanding of the pharmacy network structure, rates, MAC pricing, provider demographics, and related operational components.
• Assist in maintaining and updating pharmacy network design, pharmacy demographic data, MAC operations, reimbursement methodologies, and network-related system updates.
• Provide guidance on pricing strategies, and implementation considerations for pharmacy reimbursement.
• Conduct research and analysis on claims, pharmacy inquiries, MAC-related issues, and other pricing or reimbursement discrepancies.
• Develop and maintain operational audit tools, provide corrective action follow-up, and support audit activities across the network.
• Create analytical and operational reports related to network performance, MAC activity, Audit claims, pharmacy operations, and client-specific requests.
• Lead or support ad-hoc analysis and reporting to assist internal stakeholders in network decision-making.
• Assist with establishing and updating procedures related to accurate claims adjudication and network maintenance.
• Participate in policy and procedure development for Pharmacy Network operations and support continuous improvement initiatives.
• Build collaborative relationships with internal departments to ensure accurate implementation of network contracts, pricing, and related updates.

Benefits

• Best Employer: PDMI was voted Best Employer in Ohio for the sixth consecutive year in 2026!
• Meaningful Work: Contribute to improving healthcare quality and efficiency.
• Collaborative Environment: Work with passionate professionals who share your drive.
• Exciting Challenges: Every day brings new opportunities to excel.
• Flexible Work: Fully remote opportunity with a company that cares.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level