Your Role
The Pharmacy Benefit Implementation team is responsible for the accurate and timely build and deployment of Pharmacy Benefits and Networks to support online claims adjudication at participating pharmacies. The Business Analyst, Senior will report to the Senior Manager, Pharmacy Benefit Implementation. In this role you will represent the Pharmacy Benefit Implementation team as a subject matter expert for project tasks, documentation review, setup validation and reporting.
Your Work
In this role, you will:
- Provide complex analytical support through the analysis and interpretation of data in support of cross-functional business operations
- Build business cases for new business initiatives (cost/benefit analysis)
- Develop, prepare, and analyze reports with complex analysis and data for management review, and present to various levels of management
- Define business requirements and provide analysis to increase operational efficiency
- Provide analytical support for multiple, complex cross-functional projects simultaneously; establish work plans and timelines
- Validate critical time bound documentation for accuracy against setup intent and regulatory requirements
- Collaborate with cross functional teams to gather business requirements and options for execution of those requirements-
- Work with contracted vendors and others to maintain and validate Pharmacy Network Hierarchy and Rates, Pharmacy
Benefit Architecture Templates and other Pharmacy Benefit data - Investigate, troubleshoot and facilitate resolution of Pharmacy Benefit & Network related defects and incidents
- Support internal and external audits with reporting, subject matter expertise and representation where required
- Support Pharmacy Benefit Implementation team through cross training to help meet crucial deliverables and service
level agreements
Your Knowledge and Experience
- Requires a bachelor's degree or equivalent experience
- Requires at least 5 years of prior relevant experience
- Experience with interpreting pharmacy reporting and claims data using industry standard systems greatly desired