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Computer Consultants International, Inc IT Senior Pharmacy Business Analyst Lead (Job ID: 603175) in Raleigh, North Carolina

IT Senior Pharmacy Business Analyst Lead (Job ID: 603175)

  • 2105 Umstead Drive, Raleigh, NC 27603, USA

  • Full-time

Company Description

Computer Consultants International, Inc. (CCI) is an IT Consulting Firm with more than 18 years experience providing effective, expert-level services in industries such as Construction, Technology, Finance, Healthcare, and Government. CCI focuses on building long-term relationships while completing projects from design to delivery. People are CCI's key component for success. Recruiting utmost-quality individuals for our clients, CCI fields a workforce of individuals who are selected not only because of their technical qualifications but also for their achievements as substantial, contributing human beings. In government work and in the commercial market, high standards of ethics and accountability are critical. Therefore our people are chosen for their integrity and ability to maintain relationships, as well as expertise in their field. To learn more about CCI, visit us online at www.cci-worldwide.com.

Job Description

CCI is seeking a Senior Pharmacy BA Lead to perform Business Analysis work related to support the Managed Care Transition Project.

This position is responsible for the following activities:

•Demonstrated knowledge in creating test scenarios/cases in consultation with the business owners, hands-on testing, test results review, and proactively identifying issues and providing resolutions/recommendations

•Proven knowledge in Medicaid or similar claims (pharmacy) processing systems

•Extensive knowledge of pharmacy claims and business policies

•Thorough knowledge of system functional areas such as recipient, provider, prior authorization, reference, program integrity, financial and claims

•Thorough knowledge of Federal and State regulations, statutes, and rules

•Knowledge base/experience with encounter claims and be ready to lead any work effort pertaining to encounter claims

•Expert knowledge on SQL, EDI, X12, NCPDP, HL7, HIPAA PHI, ICD-10

•Clear understanding of the deliverables process, e.g. System Documentation release,

•Working knowledge of a defect process

•Proven experience with the system development life cycle (SDLC)

•Experience working on large Federal/State contracts

•Proficient with Microsoft Word, Excel, Visio, Project, OneNote, Outlook, and PowerPoint


Experience with Healthcare Pharmacy Claims Processing. Required. 3 Years

Experience in the review, analysis and reporting of test results. Required. 5 Years

Experience on testing web applications. Required. 5 Years

Excellent verbal and written communication skills with the ability present to both technical and business audiences. Desired.

Proven experience developing SQL queries. Required. 2 Years

Knowledge of Agile Methodology. Highly desired. 3 Years

Experience in working with the Business Teams to write Business and QA Documents. Required. 3 Years

Experience in validating all pharmacy interfaces/files. Required. 3 Years

Additional Information

For immediate consideration, please send your resume to hire(at)cci-worldwide.com with "603175-NC" Subject Line

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