What are the responsibilities and job description for the Business Analyst Healthcare-PBM position at Nityo Infotech Corporation?
Job Details
Job Role: Business Analyst Healthcare-PBM
Job location: Hartford, CT or Richardson, TX or Raleigh, NC or Tempe, AZ or Indianapolis, IN
Job Type: Full Time
Client is seeking Business Analyst Healthcare-PBM. This role requires close partnership and collaboration with other Business Stakeholders and Subject Matter Experts. Essential Job Duties include managing Health Plan Applications Deployment aligned to Industry best practices and translating functional & technical requirements into implementation work package.
Required Qualifications:
Candidate must be located within commuting distance of Hartford, CT or Richardson, TX or Raleigh, NC or Tempe, AZ or Indianapolis, IN and be willing to relocate to the area.
- Bachelor s degree or foreign equivalent required from an accredited institution. Will also consider three years of progressive experience in the specialty in lieu of every year of education.
- At least 8 years of Information Technology experience.
- At least 4 years' experience with healthcare payer, preferably on Claims, Benefits, and Care Management.
Preferred Qualifications:
At least 5 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 at least 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, Precept, 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.
