DHHS- IT Senior Pharmacy BA Specialist

DHHS- IT Senior Pharmacy BA Specialist

Location: Dix Campus Raleigh North Carolina

Duration: Long Term

Client: State of NC

NC Department of Health and Human Services (DHHS) is seeking a Senior PBM BA Specialist to lead Business and Technical Analysis related to assist with the MES PBM module implementation.

NC Department of Health and Human Services (DHHS) is seeking a senior Business Analyst with Technical expertise to assist with implementing and supporting the Medicaid Enterprise System (MES) Pharmacy Benefits Management (PBM) module. The PBM Business Analyst works with the Product owner, business users, vendors, multiple stakeholders, and executives to analyze and gather detailed business requirements, document processes in relation to implementing the PBM module. The PBM Business Analyst balances strategies between Business functionality and technical requirements.

The requirements for this position include but not limited to the following:

• Four or more years of Pharmacy Benefits Management business and system experience
• Extensive PBM domain knowledge
• Thorough knowledge of statutes, and rules regarding PBM module
• Ability to evaluate business processes, anticipate requirements, uncover areas for improvement, coordinate and experienced with implementing software solutions.
• Experience working on large Federal/State programs
• Ability to collaboratively work with multiple business units, vendors, teams, and stakeholders
• Ability to manage multiple competing tasks
• Extensive experience with system development life cycle (SDLC), business requirement gathering and analysis
• Experience documenting requirements and other project deliverables.
• Experience working with SQL, querying database tables, writing complex queries, and generating reports.
• Ability to perform user acceptance testing, documenting, and managing defects.
• Experience working with and designing system integrations and interfaces
• Knowledge in NCPDP, Drug Rebate Processing, RetroDUR, EDI, X12, HL7, HIPAA PHI, ICD-10
• Proficient with Microsoft Word, Excel, Visio, PowerPoint, Project, Outlook, and OneNote

The following skills are preferred:

• Managed Care and Medicaid experience
• Project Management experience
• Experience or familiarity in interfacing with Systems Integrator Platform
• Experience with JIRA, SCRUM, and Agile methodologies
• Ability to prioritize projects based on business needs and requirements.
• Ability to manage competing resources and priorities.
• Experience with implementation and support of Pharmacy Benefit Module (PBM) and PBM domain knowledge

Required:

• 4 Years Experience evaluating business processes, anticipating requirements, implementing software solutions.
• 7 Years Experience working on large Federal / State programs
• 7 Years Excellent verbal and written communication skills with the ability present to both technical and business audiences.

Required:

• 4 Years Knowledge of Agile Methodology
• 3 Years Experience in working with the Business Teams to write Business and QA Documents.
• 7 Years Experience designing system integrations and interfaces.