Position: Sr. Business Analyst with PBM Experience
Location: Richmond, Norfolk, VA, or Mason, OH or Wallingford, CT
Duration: 12 Months
Job description:
- More than 4 years working experience with Pharmacy Benefit Manager (PBM) / Pharmacy spectrum as Business Analyst
- More than 8 years total healthcare experience
- Working experience with any of the below PBM
- Demonstrated Working experience in Payer-PBM interfaces (few key entities from Pharmacy/PBM...
Position: Sr. Business Analyst with PBM Experience
Location: Richmond, Norfolk, VA, or Mason, OH or Wallingford, CT
Duration: 12 Months
Job description:
- More than 4 years working experience with Pharmacy Benefit Manager (PBM) / Pharmacy spectrum as Business Analyst
- More than 8 years total healthcare experience
- Working experience with any of the below PBM
- Demonstrated Working experience in Payer-PBM interfaces (few key entities from Pharmacy/PBM spectrum)
1. Member Eligibility
2. Product/Benefit
3. Claim Processing
4. Prior Authorization
5. Formulary
6. Consumer/Member portals & Mobility applications
7. Medicare/Medicaid, PDE, Encounter
8. Coordination of Benefits
9. NCPDP layout and EDI Rx transactions
10. Specialty Pharmacy
11. Mail order Pharmacy
- Excellent knowledge in Elicitation of Business requirements by collaborating with Business sponsors
- Efficient in translating Business Requirements into Functional and Non-Functional Requirements
- Strong communication skillset who can be engaged with business stakeholders as Pharmacy domain SME
- Experienced in User Acceptance Testing (UAT)
- Strong exposure to Agile and Waterfall - Model and tools (eg: JIRA, Confluence etc)
Good to have:
- Working experience with PBM migration with any of the leading Payers
- Certified in Agile practices - SAFe® Practitioner, Scrum Master etc
- Certifications in Business Analysis
- PMP
--
Regards
Mahesh Kumar
Resourcing Specialist
Desk No: 201-528-5307 Ext: 422
mahesh@sparinfosys.com
Location: Richmond, Norfolk, VA, or Mason, OH or Wallingford, CT
Duration: 12 Months
Job description:
- More than 4 years working experience with Pharmacy Benefit Manager (PBM) / Pharmacy spectrum as Business Analyst
- More than 8 years total healthcare experience
- Working experience with any of the below PBM
- Demonstrated Working experience in Payer-PBM interfaces (few key entities from Pharmacy/PBM spectrum)
1. Member Eligibility
2. Product/Benefit
3. Claim Processing
4. Prior Authorization
5. Formulary
6. Consumer/Member portals & Mobility applications
7. Medicare/Medicaid, PDE, Encounter
8. Coordination of Benefits
9. NCPDP layout and EDI Rx transactions
10. Specialty Pharmacy
11. Mail order Pharmacy
- Excellent knowledge in Elicitation of Business requirements by collaborating with Business sponsors
- Efficient in translating Business Requirements into Functional and Non-Functional Requirements
- Strong communication skillset who can be engaged with business stakeholders as Pharmacy domain SME
- Experienced in User Acceptance Testing (UAT)
- Strong exposure to Agile and Waterfall - Model and tools (eg: JIRA, Confluence etc)
Good to have:
- Working experience with PBM migration with any of the leading Payers
- Certified in Agile practices - SAFe® Practitioner, Scrum Master etc
- Certifications in Business Analysis
- PMP
--
Regards
Mahesh Kumar
Resourcing Specialist
Desk No: 201-528-5307 Ext: 422
mahesh@sparinfosys.com
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