Pharmacy Systems Analyst

About the Organization:

The Executive Office of Health and Human Services (EOHHS) is the state’s largest secretariat and services over 2 million people through its 22,000 employees and oversees expenditures of $22 billion annually. The mission of EOHHS is to promote the health, resilience, and independence of the nearly one in every three residents of the Commonwealth we serve. Our public health programs touch every community in the Commonwealth. To learn more about EOHHS, please visit https://www.mass.gov/orgs/executive-office-of-health-and-human-services.

About the Role:

The Executive Office of Health and Human Services IT Team (EOHHS IT) supporting the MassHealth program is seeking a Pharmacy Systems Analyst responsible for supporting the pharmacy system, MassRx. MassRx is a claims processing and rebate system, which processes around 26 million claims annually. The system generates around 1.6 billion in pharmacy payments to our Fee-For-Service Providers and another 1.6 billion in rebates returned to MassHealth from drug manufactures on our Fee-For-Service and Managed Care drug spend.

EOHHS IT is looking for a well-organized, result driven candidate who possesses leadership qualities. The ideal candidate will have extensive experience with pharmacy claims, National Council for Prescription Drug Programs (NCPDP) standards, and contracting/vendor management. The ideal candidate will be comfortable working in a matrix organization, have IT system analyst experience, as well as experience supporting all phases of a Software Development Life Cycle (SDLC) for enterprise applications including, but not limited to requirements, design, development, testing, and implementation. This role requires a proactive individual who can lead system changes and enhancements, ensuring the integrity and efficiency of our processes.

The incumbent of this role will work closely with the MassHealth IT Director and Director of Pharmacy Technology and Informatics for MassHealth, as well as broader MassHealth, EOHHS IT, and ForHealth teams supporting MassHealth and the pharmacy unit.

The primary work location for this role is 100 Hancock St, Quincy, Massachusetts 02179. The work schedule for this position is Monday through Friday, 9:00AM to 5:00PM EST. This position is expected to follow a hybrid model of reporting to work that combines in-office workdays and work from home days as needed. Occasional evening and/or weekend support may be required, as this position will be supporting release/production issues for systems that are accessible and operational around the clock, 24 hours a day, 7 days a week.

Responsibilities:

• Lead the development, implementation, and maintenance of the pharmacy claims processing and rebating system enhancements.

• Be accountable for the full Software Development Life Cycle (SDLC) for system changes, including requirements gathering, design, development, testing, and deployment for assigned tickets.

• Write and manage change orders, ensuring all changes are documented and approved by stakeholders.

• Prioritize system change requests through meetings with end users and monitor programming development to ensure that implementation time frames are met.

• Prepare status reports for end users.

• Create Requirements documentation for all system enhancements.

• Create and assist staff in developing detailed design documents and technical specifications based on user requirements and use cases.

• Analyze software development deliverables such as requirement documents, detailed design documents and use cases for thoroughness and detail.

• Ensure system reliability, performance, and scalability.

• Conduct system maintenance, updates, and optimizations.

• Develop and execute comprehensive test plans to ensure system changes meet requirements and maintain system integrity.

• Identify production problems and develop problem resolution and error correction strategies.

• Resolve system issues by working closely with development and support teams.

• Apply in-depth knowledge of pharmacy claims processing and NCPDP standards to system development and troubleshooting.

• Ensure compliance with relevant regulations and standards.

• Collaborate with internal and external stakeholders to understand business needs and translate them into technical requirements in a multi-agency environment.

• Coordinate work with peers, managers, and Development Team to ensure timely and error free operation and modification of the Pharmacy System.

• Provide technical guidance and support to other team members and departments.

• Act as Subject Matter Expert of the system to meet specific needs and give advice to teams.

• Maintain comprehensive documentation for system processes, changes, and enhancements.

• Provide training and support to users and stakeholders on system functionality and changes.

• Review changes in State and Federal regulations to determine the impact on existing systems and recommends system modifications to accommodate these changes.

• Support procurement activities such as writing technical requirements and reviewing/scoring responses.

Preferred Qualifications:

• Three (3) years of experience in an IT Business/Systems Analyst role, preferably with a focus on Pharmacy/Healthcare claims processing, is required. Five (5) plus years of experience is preferred.

• Experience working with pharmacy claims and knowledge of National Council for Prescription Drug Programs (NCPDP) standards.

• Experience working on systems that are accessible and operational around the clock, 24 hours a day, 7 days a week.

• Proven experience in leading system changes and managing all phases of a Software Development Life Cycle (SDLC).

• Highly analytical, with the ability to independently analyze, document findings, and recommend solutions.

• Strong diagnostic and problem-solving skills, with the ability to analyze complex technical and business challenges and implement effective solutions.

• Excellent attention to detail, ensuring accuracy in analysis, documentation, and system configurations.

• Strong communication skills, with the ability to convey technical information to non-technical stakeholders.

• Demonstrated ability to work independently, as well as within project teams, providing relevant system analysis services.

• Excellent interpersonal skills necessary to interact effectively with various levels of staff, including project managers, developers, business analysts, systems analysts, SQA analysts, business users/stakeholders, and data processing personnel of other agencies and companies.

• Ability to work in a complex and dynamic environment, managing multiple priorities effectively.

• Project management skills, including experience with Agile methodologies.

• Experience with large-scale healthcare systems, ensuring compliance with industry regulations and optimization of IT infrastructure.

• Experience supporting pharmacy IT systems, ensuring system stability, troubleshooting issues, and optimizing performance to meet business and regulatory requirements.

• Experience with Medicaid rebating including processing, validation, and ensuring compliance with state and federal guidelines.

• Experience with system procurement and implementation, from requirements gathering to deployment.

• Vendor management experience, including contract negotiation, performance monitoring, and fostering strong partnerships to ensure alignment with business objectives.

Certifications:

• Relevant Business/Systems Analyst certifications are desired but not required.

If you require assistance with the application/interview process and would like to request an ADA accommodation, please click on the link and complete the ADA Reasonable Accommodation Request Form.

For questions, please the contact the Office of Human Resources at 1-800-510-4122 and select option #4.

Salary placement is determined by a combination of factors, including the candidate’s years of directly related experience and education, and alignment with our internal compensation structure as set forth by the Human Resources Division’s Hiring Guidelines. For all bargaining unit positions (non-management), compensation is subject to the salary provisions outlined in the applicable collective bargaining agreement and will apply to placement within the appropriate salary range.

Comprehensive Benefits

When you embark on a career with the Commonwealth, you are offered an outstanding suite of employee benefits that add to the overall value of your compensation package. We take pride in providing a work experience that supports you, your loved ones, and your future.

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