SQL Analyst

Role: SQL Analyst

Location: Remote

Job Description

We are seeking experienced SQL engineer with strong PBM (Pharmacy Benefit Management) Eligibility domain knowledge. The role requires hands-on expertise in SQL query development, data validation, and issue analysis. The candidate will be responsible for manually validating eligibility files prior to ingestion and collaborating closely with the Customer EDI Team to analyze and report data issues.

Key Responsibilities

Develop, optimize, and execute complex SQL queries to validate eligibility and related PBM data

Perform manual validation of eligibility files before they are loaded into downstream systems

Analyze data discrepancies, eligibility errors, and file-related issues

Document findings clearly and report issues to the Customer EDI Team in a timely manner

Support root cause analysis for eligibility failures or mismatches

Ensure data accuracy, completeness, and compliance with PBM eligibility requirements

Work closely with EDI, operations, and technical teams to resolve data issues

Required Skills and Qualifications

Overall, 8+ years of experience required.

Strong hands-on experience with SQL (complex joins, subqueries, aggregations, validations)

Proven experience in PBM Eligibility processing and validation

Solid understanding of eligibility file formats and data flows in PBM environments

Experience performing manual data validation and reconciliation

Strong analytical and problem-solving skills

Ability to clearly communicate issues and findings to technical and business teams

Preferred Qualifications

Prior experience working with EDI teams, especially PBM-related EDI processes

Familiarity with eligibility file standards (e.g., 834 or PBM-specific formats)

Experience supporting healthcare or pharmacy benefit systems

Attention to detail and ability to work with large datasets

Soft Skills

Strong communication and documentation skills

Ability to work independently and manage priorities

Collaborative mindset when working with cross-functional teams.