3060 IT & Software Developer jobs in the US
Business Analyst - Pharmacy Systems
$51,900 - 74,200
Gainwell Technologies LLC
President Clinton Avenue 500, Little Rock
$51,900 - 74,200
Requirements
Must:
- Over 3 years of experience in business analysis within healthcare or pharmacy IT settings.
- Bachelors degree in Business, Healthcare, Information Systems, Pharmacy, or a related discipline.
- In-depth knowledge of pharmacy benefit management operations, industry terminology, and RXclaim applications.
- Familiarity with NCPDP standards, pharmacy claims processing, drug file management (e.g., Medi-Span/First Databank), and pricing strategies (strongly preferred).
- Proven experience in drafting business requirements, user stories, and test scenarios.
- Proficiency in MS Office applications, JIRA/Azure DevOps (ADO), Visio, or similar software.
- Exceptional analytical, documentation, communication, and problem-solving skills.
Responsibilities
- Gather, document, and validate business, functional, and technical criteria for pharmacy IT systems (e.g., POS, DUR, pharmacy claims processing, RTBT, Preferred Drug Lists).
- Interpret regulatory and policy updates (CMS, Medicaid pharmacy regulations, rebate programs) into system impacts and requirements.
- Collaborate with business stakeholders, pharmacists, SMEs, and IT teams to establish project scope and acceptance standards.
- Evaluate pharmacy claims processing logic, NCPDP standards, pricing and reimbursement methods, and drug file updates.
- Assist in system design concerning DUR, PA workflow, clinical edits, drug coverage modules, formulary management, and rebate processing.
- Create and revise use cases, data mappings, workflows, and system configuration documentation.
- Develop test plans, scenarios, and scripts for pharmacy-related system improvements.
- Conduct UAT, regression testing, and validate updates to pharmacy modules.
- Log defects, collaborate with technical teams to resolve issues, and verify that results meet stipulated requirements.
- Aid project planning, sprint activities, and coordination across functions for release cycles.
- Provide regular updates, prepare business and technical documentation, and contribute to status reports.
- Lead meetings, requirement workshops, and stakeholder reviews.
- Monitor and analyze pharmacy program policies, CMS guidelines, and regulatory updates for system impacts.
- Assist operational teams in troubleshooting claim issues, pricing discrepancies, and pharmacy provider matters.
- Support audit preparation, documentation, and compliance-driven deliverables.
Description
We are part of a mission-driven team at Gainwell, dedicated to leveraging advanced technologies to enhance the health and well-being of the most vulnerable populations across the country and in our communities. Working at Gainwell offers a rewarding opportunity to advance your career in a flexible, supportive environment that prioritizes learning and professional growth. We provide a generous vacation policy along with educational assistance and have extensive leadership and technical development academies to help you hone your skills. Join us and experience a collaborative culture where innovation and inclusivity foster growth.
Something wrong or incorrect with this job? Tell us in the chat 💬 on the right ➡️
You can find Business Specialist salaries in the United States here.
How many Business Specialist jobs are in the United States?
Currently, there are 3060 Business openings. Check also: Project-Manager jobs, Product-Manager jobs, CRM jobs - all with salary brackets.
Is the US a good place for Business Specialists?
The US is one of the best countries to work as a Business Specialist. It has a vibrant startup community, growing tech hubs and, most important: lots of interesting jobs for people who work in tech.
Which companies are hiring for Business Specialist jobs in the United States?
ENSCO, Inc., Federal Home Loan Bank of Chicago, Hill's Pet Nutrition, Netbuilder, Kodiak Labor Solutions, Colgate-Palmolive, VenHub among others, are currently hiring for Business roles in the United States.
The company with most openings is Lockheed Martin Corporation as they are hiring for 273 different Business Specialist jobs in the United States. They are probably quite committed to find good Business Specialists.
The company with most openings is Lockheed Martin Corporation as they are hiring for 273 different Business Specialist jobs in the United States. They are probably quite committed to find good Business Specialists.