Senior Pharmacy Business Analyst & Systems Coordinator
Job Number: 255445
Job Category: Financial Analyst
Providence St. Joseph Health is calling a Senior Pharmacy Business Analyst & Systems Coordinator (Full-Time, FTE 1.0, Days) to our Murray Business Center location in Beaverton, OR.
We are seeking a Senior Business Analyst & Systems Coordinator to be responsible for the design, development, and execution of the business requirements necessary to assure the accurate processing of prescription claims at participating pharmacies utilizing eligibility, benefits, formularies and drug utilization management edits in a point-of service environment
The Senior Pharmacy Business Analyst & Systems Coordinator demonstrates expertise in multiple pharmacy systems, responsible for evaluating and leading the implementation of new and emerging technology solutions to support the pharmacy division. Serves as expert in evaluation and interpretation of pharmacy claims data, leading solutions to support high quality pharmacy benefit management. Leads coordination between internal departments, oversees contracted vendors, and interprets and implements routine and complex regulatory requirements.
In this position you will have the following responsibilities:
- Assess and determine key attributes of pharmacy and medical claims systems and other software utilized in the pharmacy department necessary to develop and execute business requirements.
- Lead and coordinate systems configurations and maintenance of pharmacy systems with contracted vendors.
- Evaluate pharmacy utilization data, identify opportunities, lead and coordinate implementations of formulary and utilization management decisions.
- Evaluate the return of paid pharmacy claims to PHP. Remediate discrepancies for all lines of business and assures that records and adjustments are managed according to regulatory requirements.
- Lead and coordinate system impact of new pharmacy products, network contract administration, and implementation of state and federal mandates, software upgrades, operational workflow discussions, and benefit structural decisions.
- Design, develop, and execute the business requirements necessary to meet the business and strategic goals of the Pharmacy division.
- Prepare reports, perform data analysis and validation for internal and external clients in timely fashion.
- Lead and coordinate division responses for RFPs to support pharmacy benefit management growth.
- Review and verify quality of other analysts’ deliverables and provides recommendations for improvement.
- Support various areas of the pharmacy division including but not limited to pharmacy claims systems and pharmacy network management, formulary management, pharmacy operations, the Medication Therapy Management program, and quality and utilization management programs.
- Make presentations to managers, directors, vendors, and staff at level appropriate for position.
- Provide analysis on business problems and create business requirements for system enhancements.
- Perform and support User Acceptance Testing for system enhancements.
- Elicit and analyze information for development of business requirements.
- Define and document medium to high complexity business workflows.
- Shared accountability in the creation of capabilities and features for agile delivery.
- Support agile business owners in helping with the creation of user stories.
- Serves as key resource on complex and/or critical issues.
- Solve complex problems and develops innovative solutions.
- Lead functional or segment teams or projects.
- Work with business counterparts on operational readiness activities to ensure necessary training and policy and procedure updates have occurred.
Required qualifications for this position include:
- Bachelor's Degree in Business administration, healthcare administration, computer science, information technology, mathematics, statistics, engineering or related field –OR- equivalent education/experience.
- Coursework/Training: Knowledge of drug categorization and medical terminology
- Four (4) years of experience as a Pharmacy Business Analyst or analyst in directly related field.
- Four (4) years of experience in managed care.
- Advanced skill in Microsoft Applications, inclusive of pivot tables, complex Visual Basic macros.
- Four (4) years of experience in retrieving data and conducting data driven analysis utilizing various analytic tools, software and techniques; hands-on experience writing SQL queries from scratch.
- Four (4) years of progressively responsible experience in pharmacy systems, leading staff through change or implementations and interfacing with senior leaders to assure appropriate visibility.
- Ability to manage and manipulate complex data sets and steps, including merges, defining new variables, and using arrays.
- Perform complex analyses of large data sets, presenting analyses, findings and recommendations to broader audience, including senior leaders.
- National Certification as Pharmacy Technician within one year of employment.
- Licensure in Oregon as a Pharmacy Technician.
Preferred qualifications for this position include:
- Coursework/Training: Project management, Six Sigma Change Acceleration Process (CAP), LEAN, and Work Out training.
- Experience working in agile methodology and/or with agile teams.
About Providence in Oregon
As the largest healthcare system and largest private employer in Oregon, Providence offers exceptional work environments and unparalleled career opportunities.
The Providence Experience begins each time our patients or their families have an encounter with a Providence team member and continues throughout their visit or stay. Whether you provide direct or indirect patient care, we want our patients to feel that they are in a welcoming place where they can be comfortable and free from anxiety. Our employees create the Providence Experience through simple, caring behaviors such as acknowledging and welcoming each visitor, introducing ourselves and Providence, addressing people by name, providing the duration of estimated wait times and updating frequently if timelines change, explaining situations in a way that puts patients at ease, carefully listening to their concerns, and always thanking people for trusting Providence for their healthcare needs. At Providence, our quality vision is simple,
"Providence will provide the best care and service to every person, every time."
Providence is consistently ranked among the top 100 companies to work for in Oregon. It is also home to two of our award-winning Magnet medical centers. Providence hospitals and clinics are located in numerous areas, ranging from the Columbia Gorge to the wine country to sunny southern Oregon to charming coastal communities to the urban setting of Portland. If you want a vibrant lifestyle while working with a team highly committed to the art of healing, choose from our many options in Oregon.
We offer a full comprehensive range of benefits — see our website for details —http://www.providenceiscalling.jobs/rewards-benefits
Our Mission As expressions of God’s healing love, witnessed through the ministry of Jesus, we are steadfast in serving all, especially those who are poor and vulnerable.
About Us Providence Health & Services is a not-for-profit Catholic network of hospitals, care centers, health plans, physicians, clinics, home health care and services guided by a Mission of caring the Sisters of Providence began over 160 years ago.Providence is proud to be an Equal Opportunity Employer. Providence does not discriminate on the basis of race, color, gender, disability, veteran, military status, religion, age, creed, national origin, sexual identity or expression,sexual orientation, marital status, genetic information, or any other basis prohibited by local, state, or federal law.