Business Analyst With Pharmacy Benefit Management Exp

[vivid_technologies]

[b]HEALTHCARE[/b]
[b]PHARMACY BENEFIT MANAGER EXP[/b]
They are looking for a PBM consultant having PBM exp from the vendor side, exp in RFP , RFQ
[b]Requirements:[/b]
• Requires a bachelor’s degree in Information Technology, Computer Science or Business or relevant work experience in business analysis, systems analysis and/or testing background.
• Prior demonstrated experience in supporting RFP creation, Proposal analysis, Award and contracting process for a large and complex vendor relationship.
• Experience with Account Implementations and transitions
[b]• Has Pharmacy Benefit Manager (PBM) and managed care experience, particularly procurement related work
• Has experience and an understanding of HIPAA regulations and URAC and NCPDP standards and accreditation[/b]
[b]• Knowledge of PBM operations; in particular Retail, Mail, Specialty, and Clinical Services (Medication Therapy Management, Retrospective Drug Utilization Review, Prior Approval, etc.) Programs.
• Ability to comparatively analyze PBM Request for Proposal responses, including:[/b]
o Review of proposed retail networks and coverage
o Review and analysis of rebate application to prescription drugs
o Understanding of pharmacy claims data and ability to interpret pertinent fields (ingredient costs, dispensing fees, quantity, etc.)
o [b]Applying drug pricing (AWP, AAC, etc.) from all channels of pharmacy to historical claims data to estimate contract pricing
• Understanding of NASCO and Facets preferred[/b]
• Excellent written and verbal communication skills

Job Description: Responsibilities:

[b]• Reviews Request for Information (RFI) and Request for Proposal (RFP) responses from Pharmacy Benefit Manager (PBM) vendors and analyzes them for the purpose of rating them.[/b]
• Serves as a liaison between the internal/external business community and the IT organization in order to provide technical solutions to meet user needs.
• Translates business requirements into functional specifications for the IT organization, manages changes to such specifications, and educates the IT organization on the direction of the business.
• Gathers information about the organization’s work processes and information flows.
• Documents existing process in technical model format in order to evaluate and define new IT solutions and implementation processes.
• Possesses an understanding of technological trends and uses this knowledge to bring solutions to business groups supported to enhance the enterprise’s competitive edge.
• Has basic knowledge in functions they support.
• Has knowledge and background of other technologies and tools.
• Has basic understanding of business, market and industry issues facing a specific business unit or function. Supports several simple to moderately complex business processes.
• Investigates and analyzes feasibility of low to moderately complex enhancements, automations and processes. Analyze, define and interpret business needs and issues by gathering, analyzing, documenting and validating the Business area(s) and user(s) technical (functional/non-functional) requirements.
• Participates in the creation of complex PRD (Project Requirements Document) which includes defining Business, User, functional and non-functional requirements needed for approval by Business and for use by Design, Development and Testing teams. Participates in creation of Requirements Management Plan (RMP) for complex projects and may create RMP for less complex projects, to define, organize and schedule requirements management and development activities.
• Participates in requirements analysis and verification sessions for complex projects and may lead requirements analysis and verification sessions for less complex projects.
• Participates in the tracking and management of open issues and assists in planning for resolution for complex projects.
• Maintains communications with technical counterparts to adopt best practices and ensure integration of specific application architecture into overall enterprise technology strategy.
• Leads testing efforts by defining, developing and implementing practices and procedures for complete end user test plans.
• Ensures all user acceptance tests are conducted and documented according to standards. Identifies and documents system deficiencies and recommends solutions.
• Responsible for overall success of user acceptance testing, including results verification and release.
• Participates in the exploration of alternative business solutions for moderately complex processes, programs or applications, and may lead exploration of alternative business solutions for less complex processes, programs or applications to create, maintain and enhance business value.
• Works closely with system analysts to help create Proof Of Concepts (POCs) and alternative.
• Reviews, edits, analyzes and creates detailed documentation of business systems and user needs.
• Responsible for writing all documentation in clear and well organized manner.
• Develops key project deliverables including requirements specifications, use cases, system test cases, training and documentation and user manuals for projects of for low to moderately complex.
• Supports the production of Requirements Traceability Matrixes (RTM) and RTM gap analysis reports for complex enhancements, automations and implementations. May produce RTM and RTM gap analysis reports for less complex enhancements, automations and implementations.
• Uses project management techniques to establish roles and responsibilities, monitor project and request status and workload, and ensure deliverables of high quality, effectiveness and timeliness.
• Manages assigned enhancements, automations and implementations from concept through implementation.
• Creates, develops and maintains project schedules for key deliverables by developing project plan, monitoring milestone completion and coordinating project progress.
• Lead for less complex enhancements, automations and implementations.

[vivid_technologies]

Contact 571-295-4947 or mail resumes at [email protected]