Gainwell Technologies · 1 day ago
Senior Professional Business Analyst - Pharmacy
Missouri, United States
Full-time
Hybrid
Mid, Senior Level
$65K/yr - $93K/yr
6+ years expGainwell Technologies is a company focused on improving the health and well-being of vulnerable communities through technology. The Senior Professional Business Analyst - Pharmacy will support pharmacy operations and configuration of automated prior authorization rules, ensuring that clients' objectives in pharmacy benefit management services are met.
Health CareInformation Technology
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
Required
Six (6) or more years of experience in a relevant pharmacy business analyst or pharmacy technician position
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 the pharmacy payer process/claims processing
Experience working with drug file data or NCPDP guidelines
Advanced knowledge in analytical software such as Microsoft Excel or SQL and other requirement-mapping tools such as Application Lifecycle Management (ALM) tools
Strong client communication skills translating client needs to actionable objectives
Strong analytical and business process re-engineering skills
Strong executive presence and communication skills to deliver messages to business leaders, clients and technical personnel
Good organization skills to balance work and prioritize tasks
Ability to work independently with minimal supervision
Preferred
3 or more years of Medicaid and Medicare experience preferred
Knowledge of prior authorization processes and criteria preferred
Benefits
Generous, flexible vacation policy
401(k) employer match
Comprehensive health benefits
Educational assistance
Variety of leadership and technical development academies
Company
Gainwell Technologies
Gainwell Technologies is a provider of Information Technology & Services. It is a sub-organization of Veritas Capital.
10001+ employees
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 StageTotal Funding
$1M2023-06-06Grant· $1M
Leadership Team
Paul N. Saleh
President and Chief Executive Officer
Gary Call
Chief Medical Officer
Recent News
bloomberglaw.com
2025-12-12
GlobeNewswire
2025-12-11
Company data provided by crunchbase