Senior Business Analyst - Pharmacy
New
Based in the United StatesFull-TimeSenior
Salary69,400 - 99,200 USD per year
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Job Details
- Experience
- 6+ years
- Required Skills
- SQLMicrosoft Excel
Requirements
- 6+ years of experience as a pharmacy business analyst, pharmacy technician, or within PBM environments.
- Strong understanding of pharmacy benefit management, claims processing, and payer system workflows.
- Experience working with Medicaid and Medicare pharmacy programs is strongly preferred.
- Knowledge of drug data sources such as FDB, Medi-Span, or Micromedex.
- Familiarity with NCPDP standards, pharmacy claims structures, and prior authorization processes.
- Strong analytical skills with experience using Excel, SQL, or similar data analysis tools.
- Ability to translate complex business needs into clear technical and operational requirements.
- Excellent communication skills with the ability to engage technical teams, clients, and stakeholders effectively.
- Strong organizational skills with the ability to manage multiple priorities independently in a fast-paced environment.
Responsibilities
- Support pharmacy benefit management (PBM) implementations, system configurations, and ongoing account maintenance activities.
- Translate business requirements into functional specifications for pharmacy benefit systems, including edits, audits, and utilization controls.
- Collaborate with clinicians, product experts, and technical teams to design and implement pharmacy payer solutions.
- Analyze and document business processes, identifying opportunities for optimization and operational improvement.
- Support configuration of formulary management, prior authorization rules, and PDL (Preferred Drug List) structures.
- Perform testing of pharmacy claims, including point-of-sale (POS) validation and system output verification.
- Use analytical tools such as Excel, SQL, or ALM platforms to assess data, validate requirements, and measure impact.
- Ensure requirements traceability, documentation accuracy, and validation of implemented solutions against client expectations.
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