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Pharmacy Business Analyst : Raleigh, NC : 12 Months Contract at Raleigh, North Carolina, USA
Email: [email protected]
From:

Jitendra Upreity,

Technocraft Sol.

[email protected]

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Job Title: Pharmacy Business Analyst

Location: Raleigh, NC

Duration: 12 Months Contract

Note: *** Candidate must be local to Georgia and be able to attend periodic in-person meetings at the office. Most of the work can be done remotely but in office meetings are scheduled. Do you accept this requirement

Responsibilities and Skills:

Job ID: 698264

Location: Raleigh NC (DHHS)

Duration: 12 months

NC Dept of Health and Human Services (DHHS) is seeking a Senior Pharmacy BA Lead to perform Business Analysis work related to support the Managed Care Transition and MES Projects.

Skill Required / Desired Amount of Experience

Experience with Healthcare Pharmacy Claims Processing Required 3 Years

Experience in the review, analysis and reporting of test results. Required 5 Years

Experience on testing web applications Required 5 Years

Excellent verbal and written communication skills with the ability present to both technical and business audiences. Desired

Proven experience developing SQL queries. Required 2 Years

Knowledge of Agile Methodology Required 3 Years

Experience in working with the Business Teams to write Business and QA Documents . Required 3 Years

Experience in validating all pharmacy interfaces/files Required 3 Years

This position is responsible for the following activities :

Demonstrated knowledge in creating test scenarios/cases in consultation with the business owners, hands-on testing, test results review, and proactively identifying issues and providing resolutions/recommendations

Proven knowledge in Medicaid or similar claims ( pharmacy) processing systems

Extensive knowledge of pharmacy claims and business policies

Thorough knowledge of system functional areas such as recipient, provider, prior authorization, reference, program integrity, financial and claims

Thorough knowledge of Federal and State regulations, statutes, and rules

Knowledge base/experience with encounter claims and be ready to lead any work effort pertaining to encounter claims

Expert knowledge on SQL, EDI, X12, NCPDP, HL7, HIPAA PHI, ICD-10

Clear understanding of the deliverables process, e.g. System Documentation release,

Working knowledge of defect process

Proven experience with the system development life cycle (SDLC)

Experience working on large Federal/State contracts

Proficient with Microsoft Word, Excel, Visio, Project, OneNote, Outlook, and PowerPoint

Keywords: quality analyst business analyst
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Tue Dec 06 23:30:00 UTC 2022

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Location: Raleigh, North Carolina