Gainwell Technologies · 1 week ago
Business Analyst - Pharmacy
Missouri, United States
Full-time
Hybrid
Mid Level
$52K/yr - $74K/yr
4+ years expGainwell Technologies is focused on improving the health and well-being of vulnerable communities through innovative technology solutions. As a Business Analyst - Pharmacy, you will play a critical role in pharmacy benefit management services, supporting implementations and configurations while collaborating with pharmacy clinicians and clients to enhance operational processes.
Health CareInformation Technology
Responsibilities
Support PBM or Drug rebate implementations and configurations
Support PBM operations and maintenance on established accounts
Work with a team of pharmacy clinicians and subject matter experts to configure the pharmacy systems to deliver services to our state clients
Assist in implementation of a pharmacy payer system
Perform Pharmacy updates including benefit plan design, edit/audit set up, utilization controls, PDL, configuration updates, and auto prior authorization parameters
Be a knowledgeable bridge between operations staff, clients, project managers and technical staff to define, document and share pharmacy business requirements and expected impact
Work with the client to develop business rules and configuration requirements
Analyze, plan, design, document or make recommendations to improve business processes to support client’s technology goals
Help verify that all requirements have been met by approving and validating test results
Testing point of sale (POS) pharmacy claims as required
Exercise your ability to use basic analytical or relational database software — such as Excel or SQL — to quantify the anticipated impact of work
Qualification
Required
Strong background in pharmacy operations
Hands-on experience supporting pharmacy claims processing
Experience with drug reference/formulary management
Experience with drug rebate programs
Experience with prior authorization workflows
Experience within a health plan, PBM, or Medicaid environment
Demonstrated ability to support operational, analytical, or configuration-related pharmacy functions
Four (4) or more years of experience in a relevant pharmacy business analyst or pharmacy technician position
Knowledge of computer programming concepts such as configuration, development, data conversion analysis and batch processing
Pharmacy Experience as a Pharmacy Technician or working for a PBM
Knowledge of drugs and drug file structures through FDB, Medispan, or Micromedex
Knowledge of the pharmacy payer process/claims processing
Experience working with drug file data or NCPDP guidelines
Preferred
2 or more years of Medicaid and Medicare experience
Knowledge of prior authorization processes and criteria
Benefits
Generous, flexible vacation policy
Educational assistance
401(k) employer match
Comprehensive health benefits
Leadership and technical development academies
Company
Gainwell Technologies
Gainwell Technologies is a provider of Information Technology & Services. It is a sub-organization of Veritas Capital.
10001+ employees
H1B Sponsorship
Gainwell Technologies has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (90)
2024 (78)
2023 (56)
2022 (96)
2021 (33)
Funding
Current Stage
Late StageTotal Funding
$1M2023-06-06Grant· $1M
Leadership Team
Paul N. Saleh
President and Chief Executive Officer
Gary Call
Chief Medical Officer
Recent News
bloomberglaw.com
2025-12-12
GlobeNewswire
2025-12-11
Company data provided by crunchbase