| Position: Business Analyst with PBM at Remote, Remote, USA |
| Email: [email protected] |
| From: Mahendra Rao, VBeyond Corporation [email protected] Reply to: [email protected] Position: BUSINESS ANALYST with PBM Location: Remote Project Type: Contractual Please find below our key expectations, Seasoned BA with documentation of user stories, BRD, Functional specs etc. Good technical understanding & working experience with developers/architects/QA Good PBM domain expertise Job Description: We are looking to onboard a Senior Business Analyst in Manager role or Individual contributor depending on experience level. This person will have deep PBM domain expertise and will help guide the roadmap and feature enhancements for the Conduent PBM product suite. This person will serve as a bridge between the Business users and/or Clinical end users (Pharmacists) and the Technical team (Developers and Testers primarily). Minimum Qualifications: Experience level: Ideally 5+ years experience working in PBM domain (Claims processing related). Willing to consider less experienced candidates who can demonstrate depth in understanding PBM area. PBM SUBJECT MATTER expertise: Candidate should have deep understanding of Pharmacy Benefit Management (PBM) business processes including Claims Adjudication, Data related processes (e.g. Eligibility data, Provider data, Drug data, Formulary data, Drug Utilization reviews) and their interconnections. Strong plus if candidate has experience with Electronic Prescriptions and Prior-Authorizations related standards. Deep understanding of related PBM standards from NCPDP. Strong plus if candidate also understands CMS regulations related to Medicare & state Medicaid Pharmacy programs. Candidate should have deep understanding of First Data Bank (FDB) Drug nomenclature and how to use FDB nomenclature in designing / configuring drug coverage (inclusions/exclusions/PA Criteria) or building Formulary / Preferred Drug Lists. In lieu of FDB, MEDISPAN data experience will be acceptable. Candidate should be well informed about current industry trends and evolving standards. College degree is preferred. Industry experience can be considered as substitute. Candidates who have strong Clinical background (e.g. Pharmacists) and some BA background are welcome to apply (provided they are willing to switch to being a full-fledged BA with inhouse training) Non-Domain Expertise: Must understand Software Development Life Cycle - including requirements management. Must be able to capture requirements, document requirements and manage requirements using requirements management tools. Must be able to document business processes using a combination of tools - Visio, Powerpoint, Excel and Word formats depending on the context and synthesize requirements into user stories, decision tables or other pertinent formats. Must have excellent communication and writing skills. Experience with SQL queries and understanding Data Models is a strong plus. Must be a team player willing to share knowledge and support team members from other areas e.g. Developers and QA Testers. Thanks & Regards, Mahendra Rao || Technical Recruiter VBeyond Corporation I PARTNERING FOR GROWTH Hillsborough, New Jersey, USA Bottom of Form Email : [email protected] LinkedIn: linkedin.com/in/mahend-rao-966150156 Keywords: quality analyst business analyst Pennsylvania |
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| Tue Feb 27 19:37:00 UTC 2024 |