MedOne Pharmacy Benefit Solutions

Data Analyst

• Monitor and support day-to-day EDI transaction processing to ensure timely and accurate data exchange.
• Support EDI mapping, testing, and maintenance for existing and new clients/partners.
• Analyze and resolve EDI errors, rejections, and acknowledgments.
• Perform root-cause analysis on recurring EDI and data transmission issues.
• Validate data accuracy across EDI systems, source applications, and downstream consumers.
• Identify data quality, mapping, and business rule issues and partner with PLAD/ Account management teams to resolve them.
• Recommend and implement improvements to automation, monitoring, and reporting processes.
• Document data definitions, EDI workflows, mappings, and analytical methodologies.
• Analyze EDI and operational data to identify trends, risks, and performance gaps.
• Perform ad-hoc analysis to support business, operational, compliance, and audit needs.
• Communicate technical findings clearly to non-technical audiences.
• Mentor junior analysts or EDI team members as needed.
• Contribute to standardization of EDI metrics, reporting, and best practices.

Data Analyst II

Director

• Develop, govern, and optimize pricing strategies across all MedOne services and clients
• Ensure pricing competitiveness, financial sustainability, and regulatory compliance while supporting sales growth and client retention
• Lead pricing strategy, analytics, and governance while serving as a key cross-functional partner
• Direct, train, and mentor team members within the Pricing Department to ensure they are effectively performing in their responsibilities
• Manage administrative responsibilities related to pharmacy pricing, rebate contracting, client contracting, financial planning and analysis, and trend modeling
• Manage the development and maintenance of policies and procedures specific to the Pricing Team
• Elevate and maintain standard pricing contractual language ensuring contracts align with underwriting assumptions
• Support negotiations between MedOne and clients or supply chain participants to deliver innovative approaches that expand MedOne’s customer base
• Ensure MAC management and guarantee reconciliations for all lines of business are within acceptable performance thresholds
• Ensure meeting/exceeding client and supply chain expectations regarding pricing throughout the relationship lifecycle
• Assist in sales and client meetings as needed to help close new business and retain business, respectively
• Represent MedOne for all pricing related matters, both internally and externally
• Help develop new and improve existing relationships with channel partners and clients
• Lead periodic client and pharmacy reconciliations including an exchange of claims detail, analysis of claims detail and conference calls
• Ensure RFP responses for financial-related questions are complete, accurate, and maximize MedOne’s position to be awarded new business while maintaining the desired levels of profitability
• Continuously engage in process analysis and problem solving to identify opportunities that can be addressed via automation tools and/or applications

Director of Pricing

Account Executive

• Develop and manage client and partner relationships to retain business and maintain high degree of satisfaction
• Analyze plan performance reporting; interpret data and identify correlations, trends, and opportunities
• Plan for and lead client and partner plan performance review meetings; promote programs and services to clients and business partners when appropriate
• Understand contract structure, track plan performance against contract terms, and communicate performance to plan and business partners
• Strategize and collaborate with external partners and internal team members to develop and deliver proposals and contracts
• Solution for and obtain business requirements to resolve issues and provide value-add service offerings to improve client, vendor, and member satisfaction
• Oversee Account Managers associated with book of business, oversee training and development, and evaluate performance
• Identify process improvements and service offerings which increase client satisfaction and/or reduce operating expenditures
• Assist with creation and evaluation of new hire onboarding, training material and approach, and team upskilling and development
• Coach and support team through operational changes and personnel issues
• Work cross functionally with MedOne teams to improve learning and communication and foster a collaborative team-oriented environment.

Strategic Account Executive

Account Manager

• Serve as the primary client contact to build relationships, manage pharmacy benefit plans, resolve issues, and analyze performance data.
• Build and maintain business relationships by providing prompt and accurate service to promote customer loyalty.
• First point of client contact for general inquiries such as escalated member issues, plan design questions, etc.
• Assist with onboarding new clients.
• Manage client’s pharmacy benefit design updates, projects, and follow-ups.
• Organize and maintain client documentation within and outside of CRM.
• Interact directly with internal and external clients to build positive relationships.
• Analyze plan performance reporting; interpret data and identify correlations, trends, and opportunities.
• Plan for and lead client and partner plan performance review meetings; promote programs and services to clients and business partners when appropriate.
• Understand contract structure, track plan performance against contract terms, and communicate performance to plan and business partners.
• Serve as back-up to the Member Advocate team when call volume is high.
• Research and resolve issues pertaining to eligibility, claim adjudication, and billing.
• Attend client benefit fairs and open enrollment meetings.
• Contribute to department and company goals.
• Work collaboratively and cooperatively with other departments to resolve issues and improve processes.