Business Analyst with PBM

Confidential Company  •  Wallingford, CT

8 - 10 years experience  •  Healthcare

Salary depends on experience
Posted on 07/06/18 by John Frey
Confidential Company
Wallingford, CT
8 - 10 years experience
Healthcare
Salary depends on experience
Posted on 07/06/18 John Frey

Requirement details:  

 

Title               : Business Analyst with PBM

Location        : Wallingford, CT (OR) REMOTE

 

Technical Skills & Knowledge: 

 

Primary Skills: BA,Pharmacy Benefits Management(PBM)

Responsibilities:

 

1)More than 4 yrs working experience with Pharmacy Benefits Management (PBM) / Pharmacy spectrum as Business Analyst

(2)More than 8 years total healthcare experience

(3)Working experience with any of the below PBM

(4)Demonstrated Working experience in Payer-PBM interfaces (few key entities from Pharmacy/PBM spectrum)

a.Member Eligibility

b.Product/Benefit

c.Claim Processing

d.Prior Authorization

e.Formulary

f.Consumer/Member portals & Mobility applications

g.Medicare/Medicaid, PDE, Encounter

h.Coordination of Benefits

i.NCPDP layout and EDI Rx transactions

j.Specialty Pharmacy

k.Mail order Pharmacy

(5)Excellent knowledge in Elicitation of Business requirements by collaborating with Business sponsors

(6)Efficient in translating Business Requirements into Functional and Non-Functional Requirements

(7)Strong communication skillset who can be engaged with business stakeholders as Pharmacy domain SME

(8)Experienced in User Acceptance Testing (UAT)

(9)Strong exposure to Agile and Waterfall - Model and tools (eg: JIRA, Confluence etc)

 Good to have

(10)Working experience with PBM migration with any of the leading Payers

(11)Certified in Agile practices - SAFe? Practitioner, Scrum Master etc

(12)Certifications in Business Analysis

(13)PMP

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