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Senior Advisor – Rx Claims, Adjudication

Job in Stamford, Fairfield County, Connecticut, 06925, USA
Listing for: Jobtailor
Full Time position
Listed on 2026-07-20
Job specializations:
  • IT/Tech
    IT Business Analyst, Business Systems & Technology Analysis
Salary/Wage Range or Industry Benchmark: 120000 - 150000 USD Yearly USD 120000.00 150000.00 YEAR
Job Description & How to Apply Below

Responsibilities

  • Drive and complete the Business Architecture portion of business blueprints
  • Establish guiding principles and define capabilities
  • Perform functional analysis/definition and analyze/document the value chain
  • Assess organizational impacts and identify adjudication defects
  • Support resolution of high-impact claims issues and escalations
  • Advise on claims platform configuration
Requirements
  • BA/BS degree in Information Technology, Computer Science or related field of study
  • Minimum of 5 years of experience in business analyst and strategic planning, IT operations, IT leadership strategic and technical architecture
  • Minimum of 3 years in organizational management related to information architecture
  • Deep claims adjudication expertise
  • Understanding of PBM operations, payer workflows, and claims adjudication platforms
  • Ability to bridge business and technical discussions effectively
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Position Requirements
10+ Years work experience
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