Job Description :
Role: Sr. Business Analyst and PBM
Location: Wallingford CT/ Virginia Beach, VA/ Mason, OH/ St Lois, MO/ Atlanta, GA
Detailed JD:
More than 5 yrs. working experience with Pharmacy Benefit Manager (PBM) / Pharmacy spectrum as Business Analyst – with core Business team (not looking for IT business/system analysts)
More than 8 years total healthcare experience
Working experience with
o Anthem- NextRx/ProServ/ProPBM (First Preference)
o CVS (Second Preference) (Second Preference)
o Express Script (ESI)/Medco
o Prime Therapeutics
o Any other leading PBMs – MagellanRx, RxAdvance, EnviosnRx,
Demonstrated Working experience in Payer-PBM interfaces (few key entities from Pharmacy/PBM spectrum)
o Claim Processing
o Member Eligibility
Experience being part of PBM Ops team is added advantage
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
The ability to travel to attend off-site meetings with key business stakeholders
Strong exposure to Agile and Waterfall - Model and tools (e.g.: JIRA, Confluence etc