At Bayvrio, we're transforming the future of pharmacy benefit management. Our intelligent technology platform and dynamic marketplace are designed to put control back in clients' hands. Our solution enables organizations to customize pharmacy benefit strategies that align with their unique needs—driving measurable savings while improving access and quality of care. By combining smart technology with a curated, modular marketplace, we challenge the limitations of today’s broken system.  

We are looking for passionate, innovative people to help lead to that change. Every team member has the opportunity to make a real impact by helping develop solutions that increase transparency, flexibility, and choice for our clients and the patients they serve. Joining Bayvrio means becoming part of a collaborative team where your ideas are valued, your contributions matter, and your professional growth is supported. Ready to make an impact? Join a team that's redefining healthcare technology while building a career you'll be proud of.

About the role

Bayvrio is looking for a detail-oriented Operations Analyst to join our product team. In this role, you will be responsible for translating client benefit requirements into accurate, fully configured pharmacy benefit plans within our claims adjudication system, while also supporting the intake, validation, processing, and management of eligibility and other data files exchanged between Bayvrio, clients, and vendors.

You will work closely with clients, account management, implementation, operations, and technical teams to ensure benefit designs and data files are configured, transmitted, tested, and processed accurately and on schedule. The ideal candidate is highly organized, analytical, comfortable troubleshooting data discrepancies, and able to manage multiple priorities while maintaining a high level of accuracy.

What you'll do

Benefit Analysis & Configuration

• Gather, document, and interpret client benefit configuration requirements, including plan design, formulary setup, copay structures, pricing, network parameters, and clinical program requirements.
• Build and maintain benefit plan configurations within the claims adjudication system in accordance with client specifications and contractual requirements.
• Review and validate configured benefits against client requirements prior to implementation and go-live, identifying and resolving discrepancies before they impact claims processing.
• Serve as a subject matter resource for internal teams on pharmacy benefit design and configuration questions related to assigned client accounts.
• Troubleshoot claims adjudication issues related to benefit configuration and coordinate resolution with appropriate technical and operational teams.
• Maintain accurate documentation for plan configurations, benefit changes, testing, and client requests.
• Support client implementations, open enrollment changes, and ongoing benefit updates while managing timelines to ensure on-time delivery.
• Monitor configured benefits post-implementation to confirm ongoing accuracy and compliance with client and contract requirements.

File Management & Data Operations

• Oversee the daily receipt, validation, and processing of eligibility and other data files, including 834s, custom layouts, and flat files, through SFTP/EDI and other file transfer methods.
• Monitor file transmission schedules and identify, investigate, and resolve missed, delayed, incomplete, or malformed files.
• Validate incoming files for formatting, mapping, completeness, and data accuracy and coordinate resolution of discrepancies with appropriate internal teams and external partners.
• Maintain file specifications, layouts, mapping documentation, and processing procedures for client and vendor connections.
• Track file processing status and maintain accurate audit trails, logs, and documentation to support operational and compliance requirements.
• Support the setup and testing of new SFTP/API file connections as part of client and vendor onboarding.
• Support testing and validation of new file layouts, eligibility feeds, and file-based integrations.
• Communicate file issues, processing status, and resolution timelines to internal stakeholders, clients, and vendors as appropriate.
• Partner with IT, implementation, operations, and other technical teams to troubleshoot file and data issues and coordinate timely resolution.

Quality & Cross-Functional Support

• Perform detailed quality reviews of benefit configurations and data files to ensure accuracy, completeness, and consistency.
• Investigate data discrepancies and determine root causes, escalating complex issues when necessary.
• Maintain organized records and documentation to support audits, implementations, troubleshooting, and ongoing account management.
• Manage multiple benefit configuration requests, file issues, implementations, and deadlines simultaneously.
• Identify opportunities to improve file processing, benefit configuration, documentation, and quality-control processes.

Qualifications

• 1–3 years of experience in pharmacy benefit management (PBM), claims adjudication, benefit plan configuration, healthcare data operations, EDI, or file management.
• Working knowledge of pharmacy benefit plan structures and claims processing concepts, including formularies, copay tiers, quantity limits, step therapy, prior authorization, and network requirements.
• Experience with pharmacy claims adjudication or benefit configuration systems.
• Familiarity with eligibility file formats, including 834s, custom layouts, and flat files.
• Experience with SFTP, EDI, file transfer protocols, or data validation processes.
• Proficiency in Microsoft Excel, including lookups, filtering, sorting, data manipulation, and spreadsheet-based analysis.
• Strong attention to detail and a systematic approach to quality review and data validation.
• Strong organizational skills with the ability to manage multiple projects, configuration requests, and file-processing activities while meeting deadlines.
• Strong analytical and problem-solving skills, with the ability to independently investigate and troubleshoot data discrepancies.
• Clear written and verbal communication skills, with the ability to translate client and technical requirements into actionable configuration and operational requirements.

• Ability to collaborate effectively with clients, vendors, account management, implementation, IT, and operational teams.

Preferred Qualifications

• Knowledge of NCPDP data elements and pharmacy claims data.
• Experience working with healthcare EDI transactions, particularly eligibility files (834).
• Experience with SQL or other tools used for data analysis and validation.
• Experience setting up or supporting SFTP/API connections.
• Experience supporting client implementations, enrollment changes, or healthcare data integrations.
• Experience maintaining file specifications, mapping documentation, and operational audit logs.