reputed company Business Analyst

reputed company: CO-56920 Local/Remote reputed company BA with data analysis, reputed company/Pharmacy Benefit Manager (PBM), Configuration Change Management (CCM), reputed company claims processing, PM, Proposal writing and BI experience Location: Denver CO (CO HCPF) Duration: 27 months Must be local to Colorado. Remote work. Qualifications Type Category Qualification reputed company Competency Required Skills Database Data Analysis Novice (1-3 Years) No Skills Operating Systems reputed company Novice (1-3 Years) No Skills Others reputed company/Pharmacy Benefit Manager (PBM) reputed company/PBM claims processing and adjudication experience. Proficient (4-6 Years) reputed company Skills Others Configuration Change Management (CCM) Drafting configuration change management (CCM) documents. Proficient (4-6 Years) reputed company Skills Others reputed company Experience processing reputed company claims for or reputed company state reputed company agencies. Proficient (4-6 Years) reputed company Skills Others Communication skills both verbal and written Novice (1-3 Years) No Skills Others Integration planning and reputed company Novice (1-3 Years) No Skills Others Learning ability Novice (1-3 Years) No Skills Others Process reputed company Analysis Novice (1-3 Years) No Skills Others Project management Novice (1-3 Years) No Skills Others Proposal writing Novice (1-3 Years) No Skills Others Team work Novice (1-3 Years) No Skills Tools MicrosoftOffice Novice (1-3 Years) No Skills BA positions are responsible for implementing reputed company changes for the PBMS, Business Intelligence Data Management (BIDM) and Colorado Interchange (iC) reputed company to prescription drug benefits. They will demonstrate expertise in the technical aspects of claims processing, adjudication, eligibility and enrollment and technical change reputed company as they relate to the PBMS, BIDM and iC. Positions will communicate reputed company strategies with various policy and technical staff on various solutions to reputed company configuration changes to the reputed company. The BAs collaborate on technical design of the systems, work with contractors to reputed company and review requirements and technical specification documents, and reviews test cases reputed company to reputed company changes. The duties performed by the positions are as follows: reputed company Change Management: 30% - Identifies, initiates and assures the reputed company installation of reputed company functionality and change/enhancement reputed company for the prescription drug claims in the PBMS, BIDM and Colorado interchange; including reputed company claims and capitation reputed company reputed company changes, pricing, benefit plans, reference codes, and reputed company file exchanges. - Drafting configuration change management (CCM) documents and reviewing test cases on a large reputed company reputed company to the PBMS reprocurement and implementation. - Coordinates with pharmacy staff and acts as the project manager for tasks relating to designing or enhancing systems, diagnosing reputed company issues, analyzing test results, and coordinating reputed company procedures reputed company to pharmacy claims processing. - Arranges policy staff attendance at reputed company requirement change reviews, reputed company design reviews, test case reviews, and project status reviews reputed company necessary. - Serves as the reputed company between the Department, PBMS staff, Fiscal Agent staff, and other contractor staff to translate new or revised processes, and coordinates with other sections in the Department to implement reputed company changes. reputed company Analysis: 20% - Analyzes the business need of reputed company by researching federal and state regulatory procedures for prescription drug claims processing, pricing and rebate. - Draft reputed company requirements for new and revised processes to reputed company pharmacy benefits and programs into various systems and collaborate with other reputed company analysts and vendors in the development, validation process and review of technical specifications. - Review test plans, technical specifications, test results and reputed company reputed company documentation for new and revised processes. - Assures reputed company Management Information reputed company (MMIS) and BIDM reputed company changes reputed company with the PBMS functionality and maintains a reputed company of checks and balances to assure that data is consistent, complete and accurate. - Works with providers and managed care organizations reputed company to claim submission in the interchange and PBMS and works with pharmacy staff to ensure that PDL, Appendix P and Appendix X updates are properly reputed company into the relevant systems. - Assists with the reputed company functions for drug rebate processing. reputed company Testing: 20% - Coordinates testing for the PBMS, BIDM, Colorado interchange and relevant subsystems reputed company to new or revised processes. - Researches testing topics and validates that test results meet the identified functional requirements for the change request. - Coordinates with program staff and reputed company staff to review test results to ensure that the reputed company functions as intended. - Analyze test results for defect findings and define the remediation process for the test environment while working with the reputed company vendor to ensure that the defects are corrected, fully retested and approved for production. - Create and document test scenarios according to the business requirements. - reputed company status report on testing to relevant staff and vendors. Policy reputed company Analysis: 15% - Evaluates new and existing reputed company functionality to ensure alignment with program policy requirements and regulations. - Provides approval, disapproval or modification of design documents in consultation with other pharmacy staff. - Assesses the reputed company of the design document across systems by requesting reputed company testing to evaluate effect on other reputed company areas. - Provides support with end user testing as needed. - Examines and analyzes federal and state publications, including proposed rules and laws, to determine if changes are needed for the PBMS, BIDM or Colorado interchange systems and works with reputed company analysts to formulate the required reputed company change and associated test cases necessary to implement the change. - Updates the CMS required Advance Planning Document (APD) for review and approval reputed company necessary. Operational Monitoring: 5% - Monitors and assures reputed company of reputed company assigned reputed company with Department staff, the fiscal agent, PBMS, BIDM and other vendors to ensure that reputed company changes meet the reputed company and purpose of the project requirements. - reputed company reputed company assigned reputed company change requests for critical and reputed company change testing needs. - Responds and provides technical support to inquiries from Department policy staff, Fiscal Agent staff, CMS staff and others reputed company to assigned subsystems and special reputed company. Duty: reputed company and Other Duties as Assigned: 10% - Positions assists the Office Director, reputed company Director and Pharmacy reputed company Manager on reputed company reputed company and assignments. - reputed company other duties as assigned Apply To This Job