Gainwell Technologies is an Equal Opportunity Employer, where all qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.
Business Analyst - Pharmacy
Location
United States
Posted
26 days ago
Salary
Not specified
No structured requirement data.
Job Description
Job Requirements
- 3+ years of experience in business analysis within healthcare or pharmacy IT environments.
- Bachelor’s degree in Business, Healthcare, Information Systems, Pharmacy, or related field.
- Strong understanding of pharmacy benefit management operations and terminology.
- Familiarity with NCPDP standards, pharmacy claims processing, drug file management (Medi-Span/First Databank), and pricing methodologies (strongly preferred).
- Experience writing business requirements, user stories, and test scenarios.
- Proficiency with MS Office, JIRA/Azure DevOps (ADO), Visio, or similar tools.
- Excellent analytical, documentation, communication, and problem-solving skills.
- Experience with Medicaid pharmacy programs, MMIS, or PBM systems.
- Understanding of Clinical and DUR rules, formulary management, rebates, and PA workflows.
- Certification(s): CBAP, PMI-PBA, Agile/Scrum, or Pharmacy Technician (CPhT).
- Knowledge of CMS Medicaid regulations (e.g., CMS 42 CFR Part 455, OUD policies, CMS drug rebate programs).
Benefits
- Generous, flexible vacation policy.
- 401(k) employer match.
- Comprehensive health benefits.
- Educational assistance.
- Leadership and technical development academies to help build your skills and capabilities.
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