Business Analyst Pharmacy Systems Remote

MMC Group•Bismarck, ND

2d•Remote

About The Position

We are seeking an experienced Business Analyst with healthcare technology experience to support pharmacy and claims processing initiatives. This role serves as the critical link between business stakeholders and technical teams, ensuring requirements are accurately gathered, documented, and translated into effective system solutions. The ideal candidate will have experience working with pharmacy claims systems, PBM environments, Medicaid programs, and NCPDP transaction standards. This position offers the opportunity to collaborate with cross-functional teams while supporting business-critical healthcare technology initiatives.

Requirements

Bachelor's degree in Information Technology, Business, Healthcare Administration, or a related field.
3 to 8+ years of Business Analyst experience.
Experience supporting healthcare, pharmacy, PBM, or claims processing systems.
Strong requirements gathering, documentation, and stakeholder management skills.
Experience working within structured project and SDLC environments.
Knowledge of NCPDP standards and pharmacy claims processing.
Experience with SQL for data analysis and validation.
Advanced Microsoft Excel skills.
Experience with process modeling, workflow documentation, and business analysis tools.

Nice To Haves

Medicaid pharmacy program experience.
Familiarity with MMIS transactions and healthcare data exchanges.
Experience supporting PBM platforms or pharmacy benefit programs.
Professional certifications such as CBAP, CCBA, or similar Business Analysis credentials.
Strong analytical and problem-solving abilities.
Excellent communication and stakeholder management skills.
Ability to bridge technical and business teams effectively.
Experience working in complex healthcare or government program environments.
Self-motivated and capable of managing multiple priorities in a remote work environment.

Responsibilities

Gather, analyze, and document business, functional, and system requirements.
Translate business needs into detailed functional specifications, workflows, process maps, and user stories.
Collaborate with business stakeholders, technical teams, and external partners to ensure alignment throughout project lifecycles.
Facilitate requirements sessions, stakeholder interviews, and solution discussions.
Analyze pharmacy claims processing workflows and adjudication processes.
Support initiatives involving NCPDP transaction standards and related healthcare data exchanges.
Evaluate eligibility, prior authorization, drug data, and claims processing requirements.
Assist with issue analysis, troubleshooting, and resolution efforts related to pharmacy systems.
Identify operational inefficiencies and recommend process improvements.
Work closely with development and QA teams to support system enhancements and integrations.
Create and maintain process documentation, workflows, business rules, and system documentation.
Support solution design discussions and impact assessments.
Assist with test planning, test case development, and User Acceptance Testing (UAT).
Validate system functionality against documented requirements.
Support defect tracking, resolution, and post-implementation validation activities.
Facilitate project meetings and requirements reviews.
Support SDLC activities from requirements gathering through implementation.
Coordinate with cross-functional teams to ensure project deliverables are completed on schedule.