Business System Analyst

Brooksource; Chicago (IL); Remote; USD 110,000 - 130,000; Full time

Job summary

A leading company is seeking a Business Systems Analyst to oversee the redesign of the Pharmacy Benefits Management system for a large healthcare payer organization. This fully remote role involves critical process optimization, stakeholder collaboration, and hands-on execution to ensure compliance and efficiency in PBM operations.

Benefits

Medical insurance

Vision insurance

Qualifications

• Strong understanding of healthcare systems and benefits management.
• Experience with PBM systems or processes.
• Ability to manage project timelines and gather insights from data.

Responsibilities

• Lead the redesign of the PBM system and improve operations.
• Collaborate with stakeholders to gather detailed requirements.
• Ensure system changes meet operational efficiency and compliance.

Skills

Healthcare & Benefits Knowledge

Pharmacy Benefits Management (PBM)

Hands-On Execution

Technical Proficiency

Cross-Functional Communication

Project Management & Analytical Skills

Job description

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Healthcare Business Systems Analyst (Pharmacy Benefits Management)

6-month contract (opportunity for extension)

100% remote

The Business Systems Analyst will oversee the redesign of the Pharmacy Benefits Management (PBM) system for a large healthcare payer organization. This role is critical to transforming the technology and operations around PBM, ensuring that the current system transitions smoothly to a future state that better meets business and operational needs. This includes understanding how the PBM systems function today, and what enhancements are required to optimize processes such as self-billing and payment automation. The consultant will be responsible for leading hands-on process redesign, working closely with stakeholders to gather, validate, and execute on requirements. The ultimate objective is to ensure an efficient, seamless, and compliant PBM solution that aligns with evolving industry standards, regulatory needs (e.g., Medicare), and business objectives.

Key Responsibilities:

• System Redesign & Process Optimization: Lead the redesign of the PBM system, including benefits and clinical setup, and work hands-on to improve operations like self-billing and payment automation.
• Requirements Gathering & Documentation: Collaborate with business stakeholders, technology teams, and operations to gather detailed requirements and translate them into actionable system design documents.
• Cross-Functional Collaboration: Serve as the liaison between business and technology teams, ensuring that both sides are aligned on the goals and requirements of the PBM redesign.
• Execution & Implementation: Play an active role in the execution of the system redesign, not just directing the work, but contributing hands-on to the system build and process development.
• System Testing & Validation: Work with the team to ensure that system changes are properly validated and meet all necessary requirements for operational efficiency and compliance.
• Stakeholder Communication: Provide updates to leadership and key stakeholders on project progress, challenges, and milestones.

Required Skills & Experience:

• Healthcare & Benefits Knowledge: Strong understanding of healthcare systems and benefits management, with experience in a large payer environment.
• Pharmacy Benefits Management (PBM): Experience with PBM systems or processes
• Hands-On Execution: Ability to execute tasks independently, not just gather requirements, but also directly contribute to system build and redesign.
• Technical Proficiency: Skilled in working with data entry systems, and adept in using tools for requirements documentation and process mapping.
• Cross-Functional Communication: Strong communication skills to bridge gaps between business and technology teams.
• Medicare Knowledge: (Nice to Have) Familiarity with Medicare compliance requirements is a plus.
• Project Management & Analytical Skills: Ability to manage project timelines, gather insights from data, and apply them to system improvements.

Eight Eleven Group provides equal employment opportunities (EEO) to all employees and applicants for employment without regard to race, color, religion, national origin, age, sex, citizenship, disability, genetic information, gender, sexual orientation, gender identity, marital status, amnesty or status as a covered veteran in accordance with applicable federal, state, and local laws.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Other

• Industries

  IT Services and IT Consulting

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Inferred from the description for this job

Medical insurance

Vision insurance

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