| Technical Business Analyst / with strong Pharmacy Benefit Management (PBM) data expertise | Remote at Strong, Arkansas, USA |
| Email: [email protected] |
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http://bit.ly/4ey8w48 https://jobs.nvoids.com/job_details.jsp?id=2319730&uid= Hi Vendors, Hope you are doing well Do share with me the relevant profiles on [email protected] Role: Technical Business Analyst / with strong Pharmacy Benefit Management (PBM) data expertise Location: Louisville, KY (ET/CT Remote) About Emids: Emids is a leading provider of digital transformation solutions to the healthcare industry, serving payers, providers, life sciences, and technology firms. Headquartered in Nashville, Emids helps bridge critical gaps in providing accessible, affordable, and high-quality healthcare by providing digital transformation services, custom application development, data engineering, business intelligence solutions, and specialized consulting services to all parts of the healthcare ecosystem. With nearly 3,500 professionals globally, Emids leverages strong domain expertise in healthcare-specific platforms, regulations, and standards to provide tailored, cutting-edge solutions and services to its clients. The Role: We are seeking a Technical Business Systems Analyst (BSA) with strong Pharmacy Benefit Management (PBM) data expertise who will act as a liaison between business stakeholders and technical teams. This role is responsible for analyzing business requirements, evaluating system capabilities, and translating technical database queries into meaningful business insights related to claims adjudication, formulary management, member eligibility, drug pricing, and rebate processing. A critical function of this role involves documenting data lineage from source to target, establishing workflows, and generating detailed mapping documents for PBM data integration. The candidate should have strong SQL skills, be proficient in PBM data structures, and effectively communicate technical findings to both business and IT teams. Responsibilities: Key Responsibilities: Act as a bridge between business teams and technical teams, ensuring accurate translation of business needs into system solutions. Gather, analyze, and document business and system requirements for PBM-related data initiatives. Read, interpret, and analyze SQL queries to translate technical outputs into meaningful business insights. Establish workflows and process maps to visualize PBM data interactions (claims adjudication, eligibility validation, pricing, and rebate tracking). Develop data mapping documents that clearly define source-to-target transformations, including data lineage, business rules, and transformation logic. Work extensively with PBM datasets, including claims adjudication, member eligibility, provider network, drug pricing, rebates, and formulary management. Collaborate with data engineers, data analysts, and ETL developers to validate data integrity and transformation logic. Support data validation and testing efforts by assisting in UAT (User Acceptance Testing) and system testing. Ensure compliance with HIPAA, CMS regulations, and PBM industry data governance best practices. Stay current with PBM industry trends, including changes in NCPDP standards, rebate processing, and claims adjudication workflows. Must Have Experience: Must-Have Qualifications: 8+ years of experience as a Technical Business Systems Analyst in a PBM or healthcare data environment. Hands-on experience working with PBM data, including claims, eligibility, provider networks, drug pricing, and rebates. Strong SQL skillsability to read, write, and interpret complex queries to support data analysis and reporting. Proven experience in data analysis, data mapping, and data lineage tracking for PBM data. Excellent documentation skills, with expertise in creating BRDs (Business Requirement Documents), FSDs (Functional Specification Documents), and Data Mapping Documents. Strong familiarity with ETL processes, data warehousing, and PBM data integration. Experience with data analytics and visualization tools (Power BI, Tableau, Looker, or equivalent). Familiarity with NCPDP standards, claims adjudication workflows, and pharmacy reimbursement models. Solid understanding of HIPAA, CMS regulations, and PBM data governance best practices. Experience working in Agile/Scrum methodologies. Preferred Qualifications: Experience with PBM data exchange standards such as NCPDP, EDI 837/835, and formulary file formats. Familiarity with PBM platforms (OptumRx, CVS Caremark, Express Scripts, MedImpact, Prime Therapeutics, etc.). Exposure to Medicare Part D, Medicaid, and Commercial PBM data processing. Experience with cloud-based data platforms (AWS, Azure, P) and data pipelines for PBM data. Proficiency in Python, R, or other scripting languages for advanced data analysis. Certifications such as CBAP (Certified Business Analysis Professional), CAPM (Certified Associate in Project Management), or SQL-related certifications are a plus. Nice to Have Experience: Data Analysis, Business Requirements Documentation, BI, Advanced Analytics, Data Science, Data Modelling, Database - MS SQL Server Warm Regards Ankush Suryavanshi Sr. Talent Acquisition Specialist -- Keywords: business intelligence rlang information technology microsoft Connecticut Kentucky Technical Business Analyst / with strong Pharmacy Benefit Management (PBM) data expertise | Remote [email protected] http://bit.ly/4ey8w48 https://jobs.nvoids.com/job_details.jsp?id=2319730&uid= |
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| 07:52 PM 07-Apr-25 |