Job Description

Minimum Qualifications / Skills

• Bachelors/Degree in Computer Science or other technology field
• 10+ years of Business Analyst experience in the IT industry; 7+ years focused on PBM/Pharmacy Benefits.
• Demonstrated expertise in PBM operations: benefit configuration, formulary management, prior authorization/UM, accumulators, COB, specialty pharmacy, and pharmacy claims (NCPDP).
• Strong SQL skills (joins, window functions, CTEs); comfortable profiling large datasets and validating ETL outputs with SQL.
• Data modeling fundamentals (3NF vs. dimensional), MDM concepts, metadata management, and Data Warehouse/ETL lifecycle.
• Hands-on exposure to Microsoft Azure: Data Factory, Synapse/SQL DW, Azure SQL, Data Lake Storage Gen2, Databricks (PySpark), Service Bus/Event Hub, Logic Apps, Key Vault.
• Azure DevOps: Boards, Repos (Git), Pipelines (YAML), Test Plans; understanding of CI/CD for data and microservices.
• API & microservices literacy: REST/JSON, OpenAPI/Swagger, Postman; event-driven patterns and messaging fundamentals.
• Agile/Scrum delivery: user stories, acceptance criteria, backlog management, sprint ceremonies, burndown/burnup interpretation.
• Familiarity with healthcare standards and compliance: HIPAA privacy/security, HITRUST/SOC 2 controls; knowledge of X12 (834, 270/271, 835/837) is a plus.
• Bachelor’s degree in Computer Science, Information Systems, Engineering, Pharmacy, or Healthcare Administration; advanced degree (MBA/MHA) is a plus.
• Relevant certifications preferred: IIBA CBAP/CCBA, PSM/PSPO/CSPO, Azure (AZ-900, DP-900, DP-203).
  
  

Preferred Qualifications/ Skills

• Experience working with PBMs, health plans, specialty pharmacies, TPAs, or payer-provider platforms in US markets (Commercial, Medicare, Medicaid, ACA).
• Understanding of drug pricing and contracting constructs (AWP, WAC, NADAC, MAC lists), rebates, accumulator/maximum out-of-pocket policies, DIR/administrative fees.
• Exposure to e-prescribing and clinical standards (NCPDP SCRIPT), HL7/FHIR (nice to have).
• Partnered with SQL DBAs on performance tuning, indexing strategies, and release coordination in regulated environments.
• Experience with data quality and testing frameworks; comfort defining automated checks for pipelines and APIs; familiarity with lineage/metadata tools (e.g., Azure Purview).
• Hands-on with visualization/wireframing and documentation tools (Power BI/Tableau, Visio/Lucidchart, Confluence, Figma/Balsamiq).
• Operational awareness of observability (Azure Monitor, Application Insights, Log Analytics) and secure-by-design principles.
• Ability to work with distributed teams and stakeholders across time zones; excellent written and verbal communication.
• Immediate joiners or short notice preferred.