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Sr. Business Analyst - Pbm( Pharmacy Benefit Management )

Expired Job

Swinsoft Stamford , CT 06901

Posted 2 months ago

This is 100% onsite .

(1) More than 4 yrs working experience with Pharmacy Benefit Manager (PBM) / Pharmacy spectrum as Business Analyst * with core Business team (not looking for IT
business/system analysts)

(2) More than 8 years total healthcare experience

(3) Working experience:

a. NextRx/ProServ/ProPBM
b. (ESI)/Medco
c. Any other PBMs

(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

Skills:
Pharmacy Benefit Manager (PBM), Business Analysis
Contract
6 months


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Sr. Business Analyst - Pbm( Pharmacy Benefit Management )

Expired Job

Swinsoft