Change Healthcare Phoenix, AZ 85067
Overview of Position
The Business Systems Analyst is a subject matter expert that can configure the Pharmacy claims processor, formulary and PDL applications. They will be the power user of all systems and be able to maximize the configurability of the system such that many change requests will be completed without need for software development. This position will need to translate clinical objectives and requests into rules statements that are consumed by a rules engine. This role will need to consider the impact across multiple systems and identify the best solution that matches the requested capability.
What will be my duties and responsibilities in this job?
+ Support data and configuration maintenance of the POS, Formulary and Preferred Drug List applications by analyzing impact of data changes to the processing of real time pharmacy claims.
+ Perform system configurations by updating data driven rules within the PDL, formulary, and claim processor applications.
+ Establish and maintain effective lines of communication with Managers, team leaders, Reporting Analysts, Account Managers, members of the Project Management Team, and the client by email, instant messaging, phone, web meeting.
+ Establish relationships and expectations which will ensure responsiveness for time sensitive tasks.
+ Process system Change Requests by documenting scope, functionality, and level of effort by collaborating with requestors
+ Analyze impact of proposed changes by performing exploratory tests, review claims reports, create SQL queries when appropriate.
+ Conduct user acceptance testing for system and configuration changes. Create use cases, test plans, test scenarios and test cases based on the defined requirements
+ Document business and functional requirements by conducting interviews and facilitating meetings with the client and subject matter experts
+ Communicate business and functional requirements to developers, operations team and business users.
+ Provide support to other teams regarding application configuration and testing in person or through web conference.
+ Troubleshoot pharmacy claims processing issues using system knowledge and expertise. Expertise is developed through testing, research, and training.
What are the requirements needed for this position?
+ Years of experience: 3+ years pharmacy claims processing experience or a related field
+ Education: High School Diploma with some college courses in computer science or related field.
+ B.S. Pharmacy or Computer Science or degree in related fields preferred
What critical skills are needed for you to consider someone for this position?
+ Judgement is used in preparation of documents for review by clinicians and clients.
+ This position has the responsibility to record system updates, recommended clinical edits, system rules updates, and other configurations impacting claim payment and appropriate access to medications. This role will evaluate change requests, develop claims processor edits using existing rules engine functionality and request new rules functionality when needed by preparing detailed user stories and acceptance criteria for the product development team.
+ Standard Microsoft Word skills
+ Standard Excel
+ Minimal SQL, ability to run and alter scripts from a template
+ Working knowledge of Agile and SAFe methodologies
+ Ability to interpret rules-based logic, attention to detail, and ability to analyze data to determine outcomes of logic changes and system behavior.
What are the working conditions and physical requirements of this job?
General office duties and remote working environment.
Employees in roles that require travel will need to be able to qualify for a company credit card or be able to use their own personal credit card for travel expenses and submit for reimbursement.
Join our team today where we are creating a better coordinated, increasingly collaborative, and more efficient healthcare system!
As a federal contractor, Change Healthcare is adhering to the Executive Order which mandates vaccination. As such, we are requiring all U.S. new hires and employees to show proof of being fully vaccinated for COVID-19 or receive an approved accommodation by their date of hire, as a condition of employment.
As we continue to navigate the ever-changing COVID-19 pandemic, we remain committed to doing our part to ensure the health, safety, and well-being of our team members and our communities. Proof of vaccination or accommodations requests will be collected once an offer is accepted with Change Healthcare. All accommodation requests will be carefully considered but are not guaranteed to be approved.
Equal Opportunity/Affirmative Action Statement
Change Healthcare is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status. To read more about employment discrimination protections under federal law, read EEO is the Law at https://www.eeoc.gov/employers/eeo-law-poster and the supplemental information at https://www.dol.gov/ofccp/regs/compliance/posters/pdf/OFCCP\_EEO\_Supplement\_Final\_JRF\_QA\_508c.pdf.
If you need a reasonable accommodation to assist with your application for employment, please contact us by sending an email to email@example.com with "Applicant requesting reasonable accommodation" as the subject. Resumes or CVs submitted to this email box will not be accepted.
Click here https://www.dol.gov/ofccp/pdf/pay-transp\_%20English\_formattedESQA508c.pdf to view our pay transparency nondiscrimination policy.
California (US) Residents: By submitting an application to Change Healthcare for consideration of any employment opportunity, you acknowledge that you have read and understood Change Healthcare’s Privacy Notice to California Job Applicants Regarding the Collection of Personal Information (https://www.changehealthcare.com/privacy-notice/privacy-notice-to-california-job-applicants) .
Change Healthcare maintains a drug free workplace and conducts pre-employment drug-testing, where applicable, in accordance with federal, state and local laws.
Change Healthcare is an equal opportunity employer. All qualified applicant will reveive consideration for employment without regard to race, color, religion, age, sex, sexual orientation, gender identity, genetic information, national origin, disability, or veteran status.