Finance Analyst, Client Financial Operations

Position Summary:

This Analyst role is a critical position for Client Financial Operations and will partner with other internal departments. This role will be an instrumental team player that will drive process improvement with our invoicing (drug spend and ancillary) and reconciliations. The individual must have a strong financial background in PBM and be comfortable working with Excel and SQL formulas to efficiently run processes.

Position Responsibilities:

• Develop team-specific KPI dashboard and conduct periodic analyses of financial results to identify positive/negative trends, operational opportunities, etc.
• Identify automation opportunities and partner with Fin Ops management and Strategic Operations to assess ROI, develop requirements, and prioritize projects based on importance and impact
• Obtain working knowledge of and assist in all invoicing aspects:
  • Lead comprehensive billing processes by analyzing inbound data from multiple sources, including multi-year contracts, client programs, and service volumes (e.g., per claim, per member, one-time fees, recurring fees)
  • Manage billing across various lines of business including commercial, public, private, and government health plans, covering drug spend and ancillary services
  • Invoice Generation: Prepare and issue invoices based on predefined billing schedules and contract terms
• System Reconciliation: Reconcile billing records between internal platforms (e.g., ERP and adjudication systems) to ensure consistency
• Contractual and Clinical Program Reconciliation for Billing: enhance reconciliation process to ensure and confirm all billable programs and administrative fees are correctly captured
• Audit Support: Assist with internal audits by providing technical or analytical support on requests
• Process Adherence: Follow established billing procedures and escalate discrepancies to senior finance staff.
• Continuous Improvement & Collaboration
• Utilize SQL or other data query applications to prepare journal entries, accruals, and adjustments as required
• Responsible for adherence to the Capital Rx Code of Conduct, including reporting of noncompliance.

Minimum Qualifications:

• Undergraduate bachelor’s degree, with a record of strong academic performance in Accounting, Finance, Actuarial Science, Statistics, Economics, or Business Administration
• 4-6 year(s) of proven experience in financial/data analysis, actuarial services, accounting, pricing, or underwriting
• Experience working with large data sets, containing both structured and unstructured data
• Knowledge in SQL, Excel, and other data visualization tools (Python experience a plus though not required)
• Ability to balance multiple complex projects simultaneously
• Strong understanding of pharmacy pricing
• Exceptional written and verbal communication skills
• Extremely flexible, highly organized, and able to shift priorities easily