Senior Business Analyst - Pharmacy

About this role

Great companies need great teams to propel their operations. Join the group that solves business challenges and enhances the way we work and grow. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values your contributions and puts a premium on work flexibility, learning, and career development.


Summary
As a
Senior Business Analyst - Pharmacy
at Gainwell, you can contribute your skills as we harness the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who thrive on finding innovative solutions to some of healthcare’s biggest challenges. Here are the details on this position.


Your role in our mission
Play a critical part in ensuring Gainwell is meeting our clients’ objectives in pharmacy benefit management (PBM) services.

- Support PBM or Drug rebate implementations and configurations
- Support PBM operations and maintenance on established accounts
- Work with a team of pharmacy clinicians and subject matter experts to configure the pharmacy systems to deliver services to our state clients.
- Assist in implementation of a pharmacy payer system.
- Perform Pharmacy updates including benefit plan design, edit/audit set up, utilization controls, PDL, configuration updates, and auto prior authorization parameters
- Be a knowledgeable bridge between operations staff, clients, project managers and technical staff to define, document and share pharmacy business requirements and expected impact
- Work with the client to develop business rules and configuration requirements
- Analyze, plan, design, document or make recommendations to improve business processes to support client’s technology goals
- Help verify that all requirements have been met by approving and validating test results
- Testing point of sale (POS) pharmacy claims as required
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