Senior Implementation Specialist
2 weeks ago
Use advanced business analysis skills to support clients through PBM implementations. As a Senior Implementation Specialist, you may be heavily involved with one or more concurrent, complex implementations. Performing in a consultative manner, sharing best practices, assisting clients resolve implementation issues and ensuring client deliverables are produced with high quality and meet the overall project timeline.
Responsibilities
Support one or more concurrent, complex projects in areas of strong subject matter expertise (benefits, eligibility, clinical, data exchange, etc.).
Identify and collaborate with client and PBM stakeholders. Act as a liaison between business stakeholders and technical teams, facilitating effective communication and managing expectations. Drive decision-making.
Elicit and capture requirements. Use requirements to create PSG deliverables for the client, provide feedback and clarify requirements as needed to support the build phase, validate client requirements against the PSG requirements library, perform requirement gap analysis, assist with final requirements walkthroughs, and secure business approval.
Ensure documentation is up-to-date and accessible to all stakeholders. Facilitate requirement walkthroughs and secure business approval.
Evaluate business processes to uncover opportunities and propose process improvement and optimization solutions.
Create process models or other value-add documents, as needed.
Facilitate discovery and creation of use cases, user stories, and test cases.
Perform impact analysis.
Advise and lead on testing strategies, timelines, areas of common focus, and client challenges.
Assist and take point with building test plans, scenarios, and cases based on client requirements.
Review and provide feedback on end-to-end test plans.
Offer insight on gaps in testing and perform test case gap analysis against the PSG test library.
Review and interpret test results for accuracy, ensuring that benefit designs are adjudicating as expected, advise on best practice defect resolution processes, and confirm that defect resolution is complete.
PSG Benefit Validation – assist with the process, including gathering data and reporting results; maintain a defect tracker; facilitate meetings to review defects, etc.
Collaborate with project managers to create meeting agendas, define scope, timelines, and milestones. Identify risks and issues, and communicate proactively with the project team.
Advise on operational readiness, develop entry and exit readiness criteria, assess implementation readiness and risk, and consult on stopgap and workaround solutions.
Provide command center support as needed.
Assist with meetings, agendas, minutes, parking lot/action items, and the change control process.
Review and collaborate with client/vendor on tasks included in project plans.
Document and share all business analysis notes throughout the project.
Review and document lessons learned throughout the phases of the project.
Prepare and perform research on the subject matter that is being presented. Consistently share best practices and lessons learned in forums with the client. Assist with the refinement of the PSG requirements library and other project documentation.
Provide peer mentoring support (as needed) to new team members (FTEs and contractors).
Facilitate PSG bi-weekly business analysis meetings.
Stay updated with industry trends, regulatory changes, and emerging technologies that may impact health plan or PBM operations.
Demonstrate consultant behaviors in all interactions, including interrogation, empathetic and communicative abilities, listening skills, and creditability.
Perform other duties as assigned.
Skills and abilities
Excellent communication and interpersonal skills
Ability to establish and maintain effective working relationships with coworkers, managers, clients, vendors, and other stakeholders
Good problem-solving skills
Demonstrated ability to deliver results to the appropriate quality and timeline metrics
Strong influencing and negotiation skills
Sound judgment and decision-making skills
Advanced subject matter expertise in domains assigned to build credibility
Strong software and computer skills, including MS Office applications
Qualifications
5+ years of business analysis experience related to pharmacy within a healthcare setting, with health plan and pharmacy benefit management experience strongly preferred
Extensive knowledge of pharmacy benefits, including subject matter expert-level understanding of:
Benefit designs and formularies
Pharmacy networks
Configuration and testing of pharmacy benefits
Bachelor's degree in related field
IIBA CCBA or CBAP certification highly desirable
Advanced requirements tool knowledge, such as Jira or Azure DevOps. Previous use of Modern Requirements for Azure DevOps a plus
WHY JOIN US?
15th Largest Broker in US
Voted " Best Place to Work" in the Insurance Industry
Awesome Benefits: 401K matching, Generous Time Off Policy, Flexible Work Options, Medical, Dental, Vision, Pet Insurance, Cancer Insurance, Wellness Programs, Employee Award Programs (Trips).
EPIC embraces diversity in all its various forms—whether it be diversity of thought, background, race, religion, gender, skills or experience. We are committed to fostering a work community where every colleague feels welcomed, valued, respected and heard. It is our belief that diversity drives innovation and that creating an environment where every employee feels included and empowered, helps us to deliver the best outcome to our clients.
Do you have experience with Jira or Azure DevOps?
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Describe your experience with Pharmacy Benefits Management implementations?
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Do you have experience with a pharmacy benefit manager and/or with health plan pharmacy functions?
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