Business Systems Analyst

Location: Florham Park, NJ (remote) • Duration: 1 year

About the role

This contract role focuses on pharmacy-benefit-management (PBM) systems, specifically claims processing, formulary design, and drug-coverage configuration.

Responsibilities

• Serve as a subject-matter expert on FDB drug nomenclature, formulary structures, and preferred-drug-list design.
• Configure drug coverage rules: inclusions, exclusions, and prior-authorization criteria.
• Apply NCPDP D.0 standards and ProDUR business rules to claims-processing workflows.
• Elicit, analyze, and translate business requirements into technical specifications.
• Collaborate with business, clinical, development, and testing stakeholders to define process workflows, use cases, and wireframes; document in Visio.
• Analyze data and simplify requirements using Microsoft Excel.
• Create and maintain product-feature documentation, support roadmap planning, and deliver PowerPoint presentations.

Requirements

• Hands-on experience with pharmacy-benefit-management (PBM) systems and claims processing.
• Familiarity with First Databank (FDB) drug nomenclature, formulary design, and preferred-drug-list configuration.
• Knowledge of NCPDP D.0 standards and ProDUR business rules.
• Clinical or pharmacist background preferred.

Skills

• Business-requirements elicitation, analysis, and translation.
• Stakeholder collaboration across business, clinical, development, and testing teams.
• Process workflows, use-case development, and wireframing; Visio documentation.
• Microsoft Excel for data analysis and requirement simplification.
• Product-feature documentation, roadmap support, and PowerPoint presentations.