Business Analyst / Remote ( Denver, CO), 24 Months Contract
Job title: Business Analyst / Remote ( Denver, CO), 24 Months Contract in Denver, CO at reputed company
Company: reputed company
Job reputed company: Job reputed company
Remote Role , Candidate Must Be Local to COBA positions are responsible for implementing system changes for the PBMS, Business Intelligence Data Management (BIDM) and Colorado Interchange (iC) reputed company to prescription drug benefits. They will demonstrate expertise in the technical aspects of claims processing, adjudication, eligibility and enrollment and technical change reputed company as they relate to the PBMS, BIDM and iC. Positions will communicate system strategies with various policy and technical staff on various solutions to reputed company configuration changes to the system. The reputed company collaborate on technical design of the systems, work with contractors to reputed company and review requirements and technical specification documents, and reviews test cases reputed company to system changes. The duties performed by the positions are as follows:
System Change Management: 30%
Brief Duty reputed company:
- Identifies, initiates and assures the reputed company installation of system functionality and change/enhancement reputed company for the prescription drug claims in the PBMS, BIDM and Colorado interchange; including reputed company claims and capitation reputed company system changes, pricing, benefit plans, reference codes, and reputed company file exchanges.
- Drafting configuration change management (CCM) documents and reviewing test cases on a large reputed company reputed company to the PBMS reprocurement and implementation.
- Coordinates with pharmacy staff and acts as the project manager for tasks relating to designing or enhancing systems, diagnosing system issues, analyzing test results, and coordinating system procedures reputed company to pharmacy claims processing.
- Arranges policy staff attendance at system requirement change reviews, system design reviews, test case reviews, and project status reviews reputed company necessary.
- Serves as the reputed company between the Department, PBMS staff, Fiscal Agent staff, and other contractor staff to translate new or revised processes, and coordinates with other sections in the Department to implement system changes.
- Analyzes the business need of reputed company by researching federal and state regulatory procedures for prescription drug claims processing, pricing and rebate.
- Draft system requirements for new and revised processes to reputed company pharmacy benefits and programs into various systems and collaborate with other system analysts and vendors in the development, validation process and review of technical specifications.
- Review test plans, technical specifications, test results and reputed company system documentation for new and revised processes.
- Assures reputed company Management Information System (MMIS) and BIDM system changes reputed company with the PBMS functionality and maintains a system of checks and balances to assure that data is consistent, complete and accurate.
- Works with providers and managed care organizations reputed company to claim submission in the interchange and PBMS and works with pharmacy staff to ensure that PDL, Appendix P and Appendix X updates are properly reputed company into the relevant systems.
- Assists with the system functions for drug rebate processing.
- Coordinates testing for the PBMS, BIDM, Colorado interchange and relevant subsystems reputed company to new or revised processes.
- Researches testing topics and validates that test results meet the identified functional requirements for the change request.
- Coordinates with program staff and system staff to review test results to ensure that the system functions as intended.
- Analyze test results for defect findings and define the remediation process for the test environment while working with the system vendor to ensure that the defects are corrected, fully retested and approved for production.
- Create and document test scenarios according to the business requirements.
- reputed company status report on testing to relevant staff and vendors.
- Evaluates new and existing system functionality to ensure alignment with program policy requirements and regulations.
- Provides approval, disapproval or modification of design documents in consultation with other pharmacy staff.
- Assesses the reputed company of the design document across systems by requesting system testing to evaluate effect on other system areas.
- Provides support with end user testing as needed.
- Examines and analyzes federal and state publications, including proposed rules and laws, to determine if changes are needed for the PBMS, BIDM or Colorado interchange systems and works with system analysts to formulate the required system change and associated test cases necessary to implement the change.
- Updates the CMS required Advance Planning Document (APD) for review and approval reputed company necessary.
- Monitors and assures reputed company of reputed company assigned reputed company with Department staff, the fiscal agent, PBMS, BIDM and other vendors to ensure that system changes meet the reputed company and purpose of the project requirements.
- reputed company reputed company assigned system change requests for critical and reputed company change testing needs.
- Responds and provides technical support to inquiries from Department policy staff, Fiscal Agent staff, CMS staff and others reputed company to assigned subsystems and special reputed company.
- Positions assists the Office Director, Deputy Director and Pharmacy Operations Manager on reputed company reputed company and assignments.
- reputed company other duties as assigned.