What are the responsibilities and job description for the Senior Business Analyst position at Avance Consulting?
Position: Business Analyst Healthcare-PBM
Location: Hartford,Connecticut,/Tempe,Arizona,/Raleigh,North Carolina,
Duration: Fulltime permanent
Required Qualifications:
At least 4 years of Information Technology experience.
At least 4 years' experience with healthcare payer, preferably on Claims, Benefits, and Care Management.
Preferred Qualifications:
• At least 4 years of experience working as a Business Analyst in healthcare domain (Health Plan, Member Enrollment, Benefit/ Plan Configuration, Provider Setup, Contract Setup, Billing and Payments, E2E Claim Processing, EDI Transactions, Medicare, Medicaid, Commercial Health Plans, COB, Accumulators)
• Candidate should have atleast 5 yrs of experience on key PBM functions like Benefit Setup, Formulary Management, Specialty Pharmacy Process, Mail Order Drug, Claims adjudication,. Clinical programs like DUR, Precert , Rebates etc
• Proficient in understanding/ analyzing/ writing SQL queries
• Knowledge of industry tools for requirement gathering, business processing modelling, defect/ CR/ Document Control
• Analytical and Communication skills
• Planning and Co-ordination skills
• Experience with project management
• Experience and desire to work in a management consulting environment that requires regular travel
