Senior System Analyst (PBM Domain)
Pay Range: $53hr - $58hr
The Senior System Analyst (PBM Domain) will take a lead role in establishing and managing operational processes for a newly transitioned function. The role involves analyzing and managing data files, ensuring data quality, coordinating with IT and offshore teams, and supporting end-to-end operational execution within the Pharmacy Benefit Management domain.
Requirement/Must Have:
- Strong experience in PBM domain including claims, eligibility, formulary, and rebates.
- Proven experience in a Senior System Analyst or lead-level role.
- Strong understanding of data structures, file processing, and data lifecycle management.
- Hands-on experience with data formats such as flat files, CSV, and XML.
- Excellent analytical and problem-solving skills.
- Strong communication and stakeholder management abilities.
- Experience coordinating with IT teams, vendors, and offshore teams.
- Ability to manage multiple tasks and prioritize in a fast-paced environment.
Experience:
- Senior-level experience in system analysis with strong PBM domain expertise.
- Experience in managing operational processes or transitioning new functions preferred.
Responsibilities:
- Analyze and understand historical data files, including structures and dependencies.
- Interpret and validate file formats, data types, and data flow processes.
- Manage daily operational activities including data management, ingestion, and conversions.
- Ensure execution of operational processes and maintain data quality standards.
- Handle email communications and coordinate with internal and external stakeholders.
- Collaborate with IT teams and offshore resources for requirement clarification and issue resolution.
- Track incoming and outgoing data files and ensure timely processing.
- Prepare and publish regular status reports highlighting progress, issues, and risks.
- Define, standardize, and improve operational processes and best practices.
Should Have:
- Experience in setting up or transitioning operational processes.
- Knowledge of healthcare data standards and compliance requirements.
- Familiarity with data validation and reconciliation processes.
- Experience with reporting tools and dashboards.
Skills:
- Strong leadership and ownership mindset.
- High attention to detail and data accuracy.
- Strong organizational and tracking skills.
- Proactive communication and collaboration abilities.
Qualification And Education:
- Bachelor’s degree in Computer Science, Information Systems, or related field preferred.