Business Analyst with PBM

Business Analyst with PBM

Location – Remote

Duration : Long Term

Job Description -

 We are looking for strong business analysts who can effectively bridge the gap between technical teams and business operations. The ideal candidates will have deep PBM and health plan experience and be comfortable translating operational requirements into business and technical solutions.

Experience with NCPDP standards, regulatory initiatives, or F6-related work is a plus, but our primary focus is finding analysts who understand the pharmacy and health plan ecosystem and can drive complex implementations forward.

Key areas of experience include:

•             PBM and health plan operations

•             Pharmacy claims processing

•             Eligibility and enrollment

•             Benefit configuration and accumulators

•             Formulary and utilization management programs

•             Requirements gathering and impact analysis

•             File mapping and data analysis

•             Testing strategy, test case development, and validation

•             Ability to work across business, operational, and technical stakeholders

 “Tekshapers is an equal opportunity employer and will consider all applications without regards to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.”