Description

Lead business and technical analysis for the Medicaid Enterprise System (MES) Pharmacy Benefits Management (PBM) module.

This role is on-site.

Responsibilities

• Analyze and gather detailed business requirements from product owners, vendors, and stakeholders.
• Document business processes and project deliverables to balance functional needs with technical constraints.
• Design system integrations and interfaces to support PBM module functionality.
• Perform user acceptance testing, including documenting and managing defects.
• Evaluate business processes to identify improvements and coordinate software solution implementations.

Required Skills

• 4+ years of Pharmacy Benefits Management (PBM) business and system experience.
• 7+ years of experience on large Federal or State programs.
• 7+ years of experience designing system integrations and interfaces.
• 7+ years of experience communicating with both technical and business audiences.
• 4+ years of experience applying Agile methodologies.
• 3+ years of experience writing business and QA documentation.
• Extensive domain knowledge of PBM statutes, NCPDP, Drug Rebate Processing, RetroDUX, EDI, X12, HL7, HIPAA PHI, and ICD-10.
• Proficiency in SQL for querying database tables, writing complex queries, and generating reports.
• Advanced proficiency in Microsoft Word, Excel, Visio, PowerPoint, Project, Outlook, and OneNote.

Preferred Skills

• Experience with Managed Care, Medicaid, and System Integrator Platforms.
• Project Management experience and familiarity with JIRA, SCRUM, and Agile methodologies.

Key Skills

Education

Any Graduate