Role: Senior System Analyst (PBM Domain) - Lead Level
Location: Woodland hills, CA
Mandatory areas – Business Analyst – 8 years of experience with strong PBM domain exposure (ideally 4–6+ years)
Must Have skills:
- Business analysis
- Data analysis
- Agile
- Governance risk & compliance
- Requirements gathering
- User acceptance testing
Mandatory, if Applicable
Domain Experience (If any) – Healthcare good to have.
Role Overview:
We are seeking a Senior System Analyst with strong PBM (Pharmacy Benefit Management) domain expertise to take on a lead role in establishing and managing operational processes for a newly transitioned function. This role requires a blend of data analysis, operational management, stakeholder communication, and coordination with IT and offshore teams.
Key Responsibilities:
Analyze and understand historical data files, including structures and dependencies Interpret and validate file formats, data types, and data flow processes Manage day-to-day operational activities including data management, data ingestion, and data conversions Ensure smooth execution of operational processes and maintain data quality standards Handle email communications and coordinate effectively with internal teams, external stakeholders, and vendor partners Collaborate closely with IT teams and offshore resources for requirement clarification, issue resolution, and testing support Track incoming and outgoing data files, ensuring timely processing and status updates Prepare and publish regular status reports, highlighting progress, issues, and risks Contribute to defining, standardizing, and improving operational processes and best practices
Required Skills & Qualifications:
Strong experience in PBM domain (claims, eligibility, formulary, rebates, etc.) Proven experience in a System Analyst or similar role, preferably at a senior or lead level Strong understanding of data structures, file processing, and data lifecycle management Hands-on experience with data formats (e.g., flat files, CSV, XML, etc.) Excellent analytical and problem-solving skills Strong communication and stakeholder management abilities Experience coordinating with cross-functional teams including IT, vendors, and offshore teams Ability to manage multiple tasks and prioritize effectively in a fast-paced environment
Preferred Skills:
Experience in setting up or transitioning operational functions/processes Knowledge of healthcare data standards and compliance requirements Familiarity with data validation and reconciliation processes Experience with reporting tools and dashboards
Key Competencies:
Leadership and ownership mindset Attention to detail and data accuracy Strong organizational and tracking skills Proactive communication and collaboration