Business Analyst with Pharmacy Claims

Amtex Systems Inc is an information technology and talent solutions company offering talent and BI consulting to the companies in US for over 25 years.

Our solutions are designed to fill resource gaps, by providing the right candidates who deliver value to the organization. Our propensity to nurture and build strong relationships with our clients helps us better understand their business demands and gives us the ability to provide services that are on time and rise above the rest.

• Lead business analysis activities for migration from NCPDP D.0 to F6.
• Gather, analyze, document, and validate business, functional, and non-functional requirements.
• Conduct stakeholder interviews, workshops, and requirements sessions with business users, pharmacy operations, compliance teams, and IT.
• Analyze existing IBM i (AS/400) applications, DB2database structures, interfaces, reports, and business workflows to identify impacts of the F6 conversion.
• Review existing RPG/RPGLE application functionality with development teams to understand current business processes and document required enhancements.
• Create and maintain Business Requirements Documents (BRDs), Functional Requirements Documents (FRDs), process flows, use cases, user stories, acceptance criteria, and data mapping documents.
• Perform end-to-end impact analysis across pharmacy claims processing, eligibility, billing, adjudication, reporting, and downstream integrations.
• Collaborate closely with developers, architects, QA, and business stakeholders throughout the Software Development Life Cycle(SDLC).
• Develop test scenarios, review test cases, support System Integration Testing (SIT), User Acceptance Testing (UAT), and defect resolution.
• Validate data using SQL and DB2 queries to support testing and business verification.
• Ensure all business requirements comply with NCPDPF6 standards and applicable healthcare regulations.
• Support implementation planning, production deployment, and post-production validation.
• Assist with change management, business readiness, and end-user documentation.

• 8 years of Business Analyst experience supporting enterprise application development projects.
• Hands-on experience working with IBM i (AS/400) applications.
• Strong understanding of DB2 for i (DB2/400) database structures and data analysis.
• Experience performing impact analysis on legacy IBM i applications.
• Ability to understand RPG/RPGLE application logic sufficiently to translate business requirements into functional specifications.
• Experience writing SQL queries for data analysis and validation.
• Familiarity with APIs, file interfaces, EDI transactions, and batch processing.
• Experience supporting Agile, Scrum, or Waterfall methodologies.