Early Career Business Analyst - Pharmacy IT

Gainwell Technologies is a leader in healthcare innovation, seeking an Early Career Business Analyst for Pharmacy IT. This role supports pharmacy benefit management programs and IT solution delivery by analyzing requirements, enhancing systems, and ensuring compliance in pharmacy services and claims processing.

Responsibilities:

• Lead the gathering, documentation, and validation of business, functional, and technical requirements for pharmacy IT systems—including POS, DUR, claims processing, RTBT, and formulary/PDL modules
• Translate CMS and Medicaid pharmacy policies, regulatory updates, and rebate program rules into system requirements and operational impacts
• Analyze pharmacy claims logic, NCPDP standards, pricing/reimbursement methods, and drug file updates to support system design and configuration
• Develop and maintain use cases, data mappings, workflows, and testing assets; execute UAT, regression testing, and validation for pharmacy system enhancements
• Support project planning, sprint ceremonies, and cross‑functional coordination while preparing documentation, status updates, and facilitating stakeholder reviews
• Provide operational and compliance support by assessing claim issues, pricing discrepancies, regulatory changes, and audit‑related documentation needs

Requirements:

• 2+ years of experience in business analysis
• Excellent analytical, documentation, communication, and problem-solving skills
• Strong understanding of pharmacy benefit management operations and terminology
• Familiarity with NCPDP standards, pharmacy claims processing, drug file management (Medi-Span/First Databank), and pricing methodologies
• Experience writing business requirements, user stories, and test scenarios
• Experience with Medicaid pharmacy programs, MMIS, or PBM systems
• Understanding of Clinical and DUR rules, formulary management, rebates, and PA workflows
• Proficiency with MS Office, JIRA/Azure DevOps (ADO), Visio, or similar tools