Healthcare Solutions Analyst

Software Technology, Inc.

San Francisco (CA)

Remote

USD 110,000 - 160,000

Full time

5 days ago

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Job summary

EPIC Insurance Brokers & Consultants seeks a Business Solutions Analyst in San Francisco to support health plans, PBMs, and healthcare clients through complex business and technology initiatives. You will adapt BA methods across engagements, translating needs into clear requirements and facilitating alignment among clients, vendors, and delivery teams.

The role requires deep healthcare domain knowledge, experience with PBM operations, and the ability to manage diverse workstreams from strategy

Qualifications

5+ years of business analysis, consulting, implementation, or transformation experience in healthcare, including client-facing work.
Hands-on experience with health plan and PBM operations.
Strong knowledge of pharmacy benefit operations and the claims lifecycle.
Experience with PBM implementations or migrations, health plan transformation, regulatory programs, product-related initiatives, vendor selection, testing, or readiness.
Bachelor’s degree or equivalent relevant experience.
Knowledge of NCPDP standards, government programs, pharmacy transaction processing, or major regulatory transitions preferred.
Experience with Jira, Azure DevOps, process-mapping tools, and advanced Excel and PowerPoint preferred.

Responsibilities

Lead discovery and analysis by asking probing questions, clarifying problems, challenging assumptions, and identifying missing information, risks, dependencies, and operational impacts.
Translate business and operational needs into clear business, functional, data, and technical requirements at the level required by the engagement.
Analyze current-state and future-state processes, systems, files, data exchanges, controls, and handoffs; document gaps and practical recommendations.
Serve as a liaison among clients, health plans, PBMs, vendors, operational teams, technical teams, and project leadership to align scope, requirements, decisions, and expectations.
Adapt BA methods and deliverables to each client and statement of work, including strategic assessments, operational transformation, regulatory initiatives, product-related support, PBM procurement, and implementation or migration programs.
Support RFP development and evaluation by reviewing requirements and vendor responses, applying scoring criteria, documenting rationale, identifying gaps, and supporting consensus discussions.
Facilitate client, vendor, and internal working sessions; capture decisions and actions; and drive follow-up to completion.
Support testing and readiness activities, including test planning, test case development, traceability, defect review, evidence validation, implementation planning, go/no-go support, and stabilization.
Create concise, client-ready deliverables that synthesize findings, options, implications, and recommendations for both executive and delivery audiences.
Own assigned workstreams and deliverables, manage priorities and documentation, escal…
Perform other duties as assigned.