Job Location: – 1285 Northland Drive Mendota Heights, MN 55120.
Job Description: –
- Ensure Anthem’s strategic business development goals with its vendors were supported through optimal management and coordination of Pharmacy benefit.
- Coordinate with front line business units to support Operational Readiness.
- Ensure that the Pharmacy data is up-to date in the Pharmacy Benefit Manager’s claims system and there are no issues at Point of Sale.
- Provide notations of performance deviations and anomalies in reports generated by the PBM and solve issues/concerns that surround them.
- Analyze and document high level processes for Medical Injectable Drugs for alignment of steps between vendor and Anthem.
- Determine specific business application software requirements to address complex business needs.
- Take into account the business issues and devise best ways to develop appropriate diagnostic and track data that will translate business requirements into usable decision support.
- Responsible for reporting and developing recommendations on data related to multiple, varied business metrics.
- Analyze business performance reports such as Enrollment, Claims, Provider and Utilization data.
- Utilize Jira, SharePoint and Confluence for issue tracking and reporting.
- Work with the programming staff to ensure requirements are incorporated into system design and testing.
- Proficient in analyzing and creating Use Cases and Use Case Diagrams using MS Visio.
- Act as a liaison between the various business units [Medical, Encounters, Lock-in teams] and being cross-functional.
- Conduct Monthly Business meetings with the stakeholders [Pharmacy Benefit Managers] to prioritize requirements for the upcoming releaseS [2019, 2020, 2021 go-live].
- Participate in JAD sessions as the designated scribe and should be responsible for documenting Minutes of the meeting.
- Perform Root Cause Analysis of the requirements to identify the key business risk areas for the project and prioritized testing.
- Actively participate in walkthroughs and meetings with Project Team members including Developers and Testers to discuss related issues.
- Generate periodic reports for clients and vendors for review.
- Prepare GAP Analysis; identify and document improving areas to meet the client’s needs.
- Act as Mediator between external and internal customers, capable of interpreting their needs and positions to ensure the success of the project.
Minimum Education Required: –
This position requires, at a minimum, a Bachelor’s degree or its working equivalent in Computer Science, Computer Information Systems, Computer technology, or a combination of education and experience equating to the U.S. equivalent of a Bachelor’s degree in one of the aforementioned subjects.