PBM Business Consultant
Core
Translates moderately complex business needs into application software requirements and leads teams of analysts on complex projects.
Role type
Senior Business Analyst / Business Consultant
Builds
Application software solutions and operational improvements for PBM operations
Domain
Healthcare / Pharmacy Benefit Management (PBM)
Required skills
Business analysis, Project management, Systems analysis, Root cause analysis, Data analysis, Process improvement, Executive reporting, Cross-functional leadership
Preferred skills
PBM operations knowledge, Pharmacy claims adjudication, Benefit configuration, Impact analysis, Operational risk assessment, SQL/Databricks, Large dataset handling, Healthcare consulting experience
Technologies
SQL, Databricks, Excel
Responsibilities
Lead teams of analysts assigned to complex projects, Determine specific business application software requirements, Analyze and design solutions to address business needs, Consult with business partners on technology implementation, Lead restitution reviews and operational investigations, Conduct complex business and claims data analyses, Partner with cross-functional teams to evaluate risks, Facilitate root cause analysis and drive process improvements, Develop impact assessment methodologies and executive-level reporting, Support strategic PBM Operations initiatives, Prepare and present findings to leadership, Maintain documentation and governance artifacts
Seniority
Senior, hands-on IC