Business Analyst - Pharmacy jobs in United States
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Gainwell Technologies · 2 days ago

Business Analyst - Pharmacy

Gainwell Technologies LLC is a company dedicated to improving health and well-being through technology. As a Business Analyst - Pharmacy, you will play a critical role in pharmacy benefit management services, supporting implementations, operations, and helping to configure pharmacy systems to meet client needs.

Health CareInformation Technology
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H1B Sponsor Likelynote

Responsibilities

Support PBM or Drug rebate implementations and configurations
Support PBM operations and maintenance on established accounts
Work with a team of pharmacy clinicians and subject matter experts to configure the pharmacy systems to deliver services to our state clients
Assist in implementation of a pharmacy payer system
Perform Pharmacy updates including benefit plan design, edit/audit set up, utilization controls, PDL, configuration updates, and auto prior authorization parameters
Be a knowledgeable bridge between operations staff, clients, project managers and technical staff to define, document and share pharmacy business requirements and expected impact
Work with the client to develop business rules and configuration requirements
Analyze, plan, design, document or make recommendations to improve business processes to support client’s technology goals
Help verify that all requirements have been met by approving and validating test results
Testing point of sale (POS) pharmacy claims as required
Exercise your ability to use basic analytical or relational database software — such as Excel or SQL — to quantify the anticipated impact of work

Qualification

Pharmacy operationsPBM experienceClaims processingSQLDrug file managementAnalytical skillsCommunication skillsTeam collaboration

Required

Four (4) or more years of experience in a relevant pharmacy business analyst or pharmacy technician position
2 or more years of Medicaid and Medicare experience
Knowledge of computer programming concepts such as configuration, development, data conversion analysis and batch processing
Pharmacy Experience as a Pharmacy Technician or working for a PBM
Knowledge of drugs and drug file structures through FDB, Medispan, or Micromedex
Knowledge of the pharmacy payer process/claims processing
Experience working with drug file data or NCPDP guidelines

Preferred

Knowledge of prior authorization processes and criteria

Benefits

Generous, flexible vacation policy
401(k) employer match
Comprehensive health benefits
Educational assistance
Variety of leadership and technical development academies

Company

Gainwell Technologies

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Gainwell Technologies is a provider of Information Technology & Services. It is a sub-organization of Veritas Capital.

H1B Sponsorship

Gainwell Technologies has a track record of offering H1B sponsorships. Please note that this does not guarantee sponsorship for this specific role. Below presents additional info for your reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (90)
2024 (78)
2023 (56)
2022 (96)
2021 (33)

Funding

Current Stage
Late Stage
Total Funding
$1M
2023-06-06Grant· $1M

Leadership Team

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Paul N. Saleh
President and Chief Executive Officer
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Gary Call
Chief Medical Officer
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Company data provided by crunchbase