Business Analyst

Must have: PBM exp.

Its functions are:

Formulary Management

Claims Processing

Utilization Management

Job Responsibilities:

• Work with other departments to ensure that the customer’s business requirements are accurately incorporated into the product, in a timely manner.

• Work with account managers and technical lead(s) to gather business requirements from customers. This includes but is not limited to meeting with customer operations to understand and document their current process, gaps and needs.

• Work with technical lead(s) to come up with a solution(s) for the identified gaps. This includes but is not limited to meetings; brainstorming while re-creating scenarios in the application; impact analysis for identified requirements.

• Work with the account manager and customer to get clarifications identified during the design process. Manage Functional Requirements Documentation Process

• Participate in FRD walk-throughs conducted by the technical leads. Actively identify gaps not addressed in the FRD or missed by the developers.

• configuration, testing, and maintenance to ensure optimal operational performance.

• Some overnight travel to customer sites (0 to 2 times per year).

• Other duties as assigned by manager

Desired Skills

• Strong verbal and written communication skills

• Familiar with utilization management processes, preferably Prior Authorization within all line of Business.

• Experience working with health plans, PBM, Specialty Pharmacy, a plus.

• Problem solving and business analysis skills with strong attention to detail

• Strong execution skills

• Highly organized and flexible

• Team Player

Key Competencies

• Communicates effectively – Attentively listens to others, provides timely and helpful information and is effective in a range of professional settings. Gives and receives feedback in a productive, professional manner. Demonstrates excellent oral and written communication skills.
• Manages Ambiguity - Operating effectively, even when things are not certain, or the way forward is not clear. Is flexible in approach and is able to adapt their approach to meet changing business needs.
• Manages complexity - Makes sense of complex, high quantity, and sometimes contradictory information to effectively solve problems. Has strong organizational skills and is able to manage multiple activities at once. Has high attention to detail.
• Ensures Accountability - Follows through on commitments and makes sure others do the same. Able to work independently as part of a small team.