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Hi Partner
Hope you are doing well.
This is Pradeep from USM Business Systems. I came across your resume, and I'm currently looking for candidates that fit the below opportunity with our Fortune Client which is new in the market.
Please go through the Job Description and let me know if you would be interested in pursuing this opportunity. Don’t Hesitate to Contact me at 703.794.5558. .You can also reach me Via Email at pradeepb@usmsystems.com, If you are interested Please reply back to my email with your updated resume in Word Format
Moving forward hearing from you!!
Role: Senior Business Analyst PBM Claims
Location: Mason, OH
Duration: 12+ months
Openings: 2
My Client is looking for a Senior Business Analyst to work with one of the leading healthcare providers in US. The ideal candidate must possess excellent background on PBM claims area. The candidate must possess excellent written and verbal communication skills with the ability and collaborate effectively with different teams.
Responsibilities
· As a Senior Business Analyst, you will
· Participate in activities related to the design, development, and maintenance of the PBM business strategies and enterprise initiatives
· Work with Pharmacy Business and IT stakeholders on business requirement elicitation
· Capturing the business needs from Commercial Plan Sponsors, Medicaid and Medicare business stakeholders
· Collaborate with other business functional groups including but not limited to Formulary management, Benefit Configuration, Pricing, and Networks, Membership and Enrolments, Finance and Reporting, Medical and Accumulator Groups
· Run query from data wearhouse applications to triage the reported claims and related issues.
· Manage, use and maintain business architecture models
· Facilitate and or actively participates in meetings related to the designated project s, both locally and internationally, with clients and or partners.
Required Sills:
· More than 8 years of total healthcare experience
· Anthem experience with Edward claims area is required
· Excellent knowledge in Elicitation of Business requirements by collaborating with Business sponsors
· Efficient in translating Business Requirements into Functional and Non Functional Requirements
· Strong communication skillset who can be engaged with business stakeholders as Pharmacy domain SME
· The ability to travel to attend off-site meetings with key business stakeholders
· Strong exposure to Agile and Waterfall Model and tools eg JIRA, Confluence etc
· Knowledge to write basic database queries
Thanks & Regards,
Pradeep Kumar
Sr US IT Recruiter
USM BUSINESS SYSTEMS
14175 Sullyfield Cir, #400, Chantilly, VA 20151
Office Locations : New York | Washington D.C | Atlanta | Dallas | Las Vegas | Seattle
703-794-5558 
pradeepb@usmsystems.com 
www.usmsystems.com
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