Senior Business Analyst

• Provide subject matter expertise in Pharmacy Benefit Management processes while leading requirements gathering, analysis, and documentation efforts.
• Collaborate with business, clinical, and technical teams to translate complex requirements into actionable solutions that support system development and configuration.

Requirement/Must Have:

• Strong experience in Pharmacy Benefit Management domain, including claims processing.
• Deep understanding of claims adjudication and related data processes.
• Expertise in industry standards and drug data management.
• Strong knowledge of Software Development Life Cycle and requirements management.
• Ability to document business processes and requirements using various tools.

Responsibilities:

• Provide subject matter expertise to development, testing, and business teams.
• Gather, analyze, and document business requirements.
• Translate requirements into technical specifications and user stories.
• Create design documents such as wireframes, workflows, and decision tables.
• Configure drug plan benefits including coverage, pricing, and authorization rules.
• Collaborate with stakeholders to understand business and clinical requirements.
• Develop process workflows, use cases, and documentation.
• Analyze data and support requirements validation activities.
• Prepare product documentation and roadmap materials.

Skills:

• Pharmacy Benefit Management domain expertise.
• Requirements gathering and documentation.
• Process modeling and workflow creation.
• Data analysis and SQL knowledge.
• Microsoft tools including Excel, Word, PowerPoint, and Visio.
• Strong analytical and problem-solving skills.
• Communication and stakeholder management skills.

Qualification And Education:

• Bachelor s degree preferred or equivalent industry experience.

Experience:

• 10+ years of experience in business analysis within PBM domain preferred.
• Experience with claims processing and drug data systems.
• Experience with requirements management tools and methodologies.
• Clinical background with business analysis experience preferred.