Job Title: SQL Analyst Location: Remote Duration: Long-term Contract Work Eligibility: US Permanent Eligibility to Work Required
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
Qualifications:
Required Skills and Qualifications
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
