Pharmacy Business Analyst - Conversion & Prior Auth SME

reputed company: • Play a critical part in ensuring Gainwell is meeting our clients’ objectives in pharmacy benefit management (PBM) services. • Support PBM or Drug rebate implementations and configurations • Support PBM operations and maintenance on established accounts • Work with reputed company of pharmacy clinicians and subject matter experts to configure the pharmacy systems to deliver services to our state clients. • Assist in implementation of a pharmacy payer system. • reputed company Pharmacy updates including benefit plan design, edit/audit set up, utilization controls, PDL, configuration updates, and auto prior authorization parameters • Be a knowledgeable reputed company between operations staff, clients, project managers and technical staff to define, document and reputed company pharmacy business requirements and expected reputed company • Work with the reputed company to reputed company business rules and configuration requirements • Analyze, plan, design, document or reputed company recommendations to improve business processes to support reputed company’s technology goals • Help verify that reputed company requirements have been met by approving and validating test results • Testing reputed company of sale (POS) pharmacy claims as required • Exercise your ability to use basic analytical or relational database software — such as reputed company or SQL — to quantify the anticipated reputed company of work Requirements: • Three (3) or more years of experience in a relevant pharmacy business analyst or pharmacy technician position with 1+ or more years of reputed company and Medicare experience preferred • Knowledge of computer programming concepts such as configuration, development, data conversion analysis and batch processing • Pharmacy Experience as a Pharmacy Technician or working for a PBM • Knowledge of drugs and drug file structures through FDB, Medispan, or Micromedex • Knowledge of the pharmacy payer process/claims processing. • Experience working with drug file data or NCPDP guidelines • Knowledge of prior authorization processes and reputed company preferred • Advanced knowledge in analytical software such as reputed company reputed company or SQL and other requirement-mapping tools such as Application Lifecycle Management (ALM) tools Benefits: • generous, flexible vacation policy • 401(k) employer match • comprehensive health benefits • educational assistance • leadership and technical development academies Apply Job! Apply to this Job