Pharmacy Business Analyst - Preferred Drug List (PDL)

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You'll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You'll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.

Summary

We are seeking a detail-oriented and collaborative Pharmacy Business Analyst (BA) with strong Healthcare Domain knowledge to support the development and optimization of Preferred Drug List (PDL) Solutions. The ideal candidate will bridge business needs and technical capabilities, ensuring that PDL initiatives are data-driven, compliant, and aligned with stakeholder goals.

Your role in our mission

• Requirements Gathering & Analysis: Collaborate with stakeholders to elicit, document, and validate business requirements for PDL-related initiatives, including formulary updates, coding workflows, and supplemental rebate processes.
• Process Mapping & Optimization: Analyze current and proposed PDL workflows (e.g., coding file generation, FMT integration, NDC updates) and recommend improvements for efficiency and compliance.
• Data Analysis & Reporting: Use SQL and reporting tools to analyze drug utilization, market share trends, and rebate impacts. Support the creation of reports such as the NDC PDL Detail Report, Surah/Dura reports, and Market Share Reports.
• Stakeholder Communication: Act as a liaison between business, clinical, and technical teams to ensure shared understanding of requirements and deliverables. Translate complex data and regulatory concepts into actionable insights.
• Compliance & Documentation: Ensure all documentation aligns with federal/state regulations (e.g., CMS, HIPAA) and internal standards. Maintain traceability matrices and support audit readiness.
• Testing & Validation Support: Assist in defining test cases and validating outputs for PDL coding files, pricing updates, and rebate reports. Participate in UAT and quality control activities.

What we're looking for

• Healthcare & Pharmacy Expertise: 5+ years of experience as a Business Analyst in Healthcare or Pharmacy Domains, with familiarity in PDL, Formulary Management Systems, and Drug Classification Standards such as NDC and RxNorm.
• Technical & Analytical Skills: Proficient in SQL and Excel, with experience in Data Visualization Tools like Power BI. Strong Analytical mindset with the ability to Develop and Maintain Accurate Data Models.
• Process & Methodology Knowledge: Solid understanding of Agile Methodologies and experience working in cross-functional teams. Skilled in interpreting RFPs and Regulatory Documents to Assess Business Impact.
• Industry-Specific Experience: Hands-on experience with Medicaid Drug Rebate Program (MDRP), Supplemental Rebate Workflows, and Pricing Methodologies including NADAC and MAC.
• Tool & Platform Proficiency: Familiarity with tools such as FMT (Formulary Management Tool), Databricks, and Unity Catalog, along with exposure to Cloud Platforms like AWS and Azure and Data Pipeline Concepts.

What you should expect in this role

• Fully remote opportunity with the option to work anywhere within the United States
• Opportunities to travel through your work (0-10%)
• Video cameras must be used during all interviews, as well as during the initial week of orientation

This posting is intended for pipelining. We will accept applications on an ongoing basis.

The pay range for this position is 69,400 - 99,200 per year, however, the base pay offered may vary depending on geographic region, internal equity, job-related knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You'll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits , and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities.

We believe nothing is impossible when you bring together people who care deeply about making healthcare work better for everyone. Build your career with Gainwell, an industry leader. You'll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for all available job role openings.

Gainwell Technologies is committed to a diverse, equitable, and inclusive workplace. We are proud to be 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), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. We celebrate diversity and are dedicated to creating an inclusive environment for all employees.