Hi 

Hope you are doing Great,

My name is Syed Siraj, and I am working with Talent Software Services. We 
are a *Service-Disabled Veteran Owned Staffing Company* providing the best 
IT Consulting and Professional Services from past 33 years. I came across 
your profile on one of the portals and wanted to reach out to you for the 
following opportunity with one of our clients.

 

*Position: Business Analyst*

*Location:  Denver, Co                                     *

*Opportunity will be 8 months with a strong chance for an extension.*

 

*Job Summary:*

   - BA positions are responsible for implementing system changes for the 
   PBMS, Business Intelligence Data Management (BIDM) and Colorado Interchange 
   (iC) related to prescription drug benefits. 
   - They will demonstrate expertise in the technical aspects of claims 
   processing, adjudication, eligibility and enrollment and technical change 
   projects as they relate to the PBMS, BIDM and iC. 
   - Positions will communicate system strategies with various policy and 
   technical staff on various solutions to develop configuration changes to 
   the system. processes and enhancement projects. 
   - The Client collaborate on technical design of the systems, work with 
   contractors to develop and review requirements and technical specification 
   documents, and reviews test cases related to system changes. 
   - The duties performed by the positions are as follows:
   System Change Management: 30% 

 

*Brief Duty Description:*

   - Identifies, initiates and assures the quality installation of system 
   functionality and change/enhancement projects for the prescription drug 
   claims in the PBMS, BIDM and Colorado interchange; including all claims and 
   capitation related system changes, pricing, benefit plans, reference codes, 
   and interface file exchanges. 
   - Drafting configuration change management (CCM) documents and reviewing 
   test cases on a large scale related to the PBMS reprocurement and 
   implementation. 
   - Coordinates with pharmacy staff and acts as the project manager for 
   tasks relating to designing or enhancing systems, diagnosing system issues, 
   analyzing test results, and coordinating system procedures related to 
   pharmacy claims processing. 
   - Arranges policy staff attendance at system requirement change reviews, 
   system design reviews, test case reviews, and project status reviews when 
   necessary. 
   - Serves as the liaison between the Department, PBMS staff, Fiscal Agent 
   staff, and other contractor staff to translate new or revised processes, 
   and coordinates with other sections in the Department to implement system 
   changes.
   System Analysis: 20% 

 

*Brief Duty Description:*

·         Analyzes the business need of projects by researching federal and 
state regulatory procedures for prescription drug claims processing, 
pricing and rebate.

·         Draft system requirements for new and revised processes to 
integrate pharmacy benefits and programs into various systems and 
collaborate with other system analysts and vendors in the development, 
validation process and review of technical specifications.

·         Review test plans, technical specifications, test results and 
provide system documentation for new and revised processes.

·         Assures Medicaid Management Information System (MMIS) and BIDM 
system changes align with the PBMS functionality and maintains a system of 
checks and balances to assure that data is consistent, complete and 
accurate.

·         Works with providers and managed care organizations related to 
claim submission in the interchange and PBMS and works with pharmacy staff 
to ensure that PDL, Appendix P and Appendix X updates are properly 
translated into the relevant systems.

·         Assists with the system functions for drug rebate processing.
System Testing:20%

 

*Brief Duty Description:*

·         Coordinates testing for the PBMS, BIDM, Colorado interchange and 
relevant subsystems related to new or revised processes.

·         Researches testing topics and validates that test results meet 
the identified functional requirements for the change request.

·         Coordinates with program staff and system staff to review test 
results to ensure that the system functions as intended.

·         Analyze test results for defect findings and define the 
remediation process for the test environment while working with the system 
vendor to ensure that the defects are corrected, fully retested and 
approved for production.
Create and document test scenarios according to the business requirements.

·         Provide status report on testing to relevant staff and vendors.
Policy Impact Analysis:15%

*Brief Duty Description:*

·         Evaluates new and existing system functionality to ensure 
alignment with program policy requirements and regulations.
Provides approval, disapproval or modification of design documents in 
consultation with other pharmacy staff.

·         Assesses the impact of the design document across systems by 
requesting system testing to evaluate effect on other system areas.

·         Provides support with end user testing as needed.

·         Examines and analyzes federal and state publications, including 
proposed rules and laws, to determine if changes are needed for the PBMS, 
BIDM or Colorado interchange systems and works with system analysts to 
formulate the required system change and associated test cases necessary to 
implement the change.

·         Updates the CMS required Advance Planning Document (APD) for 
review and approval when necessary.
Operational Monitoring:5%

 

*Brief Duty Description:*

·         Monitors and assures quality of all assigned projects with 
Department staff, the fiscal agent, PBMS, BIDM and other vendors to ensure 
that system changes meet the intent and purpose of the project requirements.

·         Track all assigned system change requests for critical and 
collaborative change testing needs.

·         Responds and provides technical support to inquiries from 
Department policy staff, Fiscal Agent staff, CMS staff and others related 
to assigned subsystems and special projects.

·         Duty: Ad Hoc and Other Duties as Assigned:10%

Brief Duty Description:

·         Positions assists the Office Director, Deputy Director and 
Pharmacy Operations Manager on ad hoc projects and assignments.
Perform other duties as assigned.

 

 

 

*Syed Siraj*

*Sr. Technical Recruiter*

*TALENT Software Services, Inc.*

*M: (952) 417-3680*

*E:* [email protected]
*W:* https://talentstaffingservices.com/

1769 Lexington Ave N; Suite 390, St. Paul, MN 55113

7950 Legacy Dr., Suite 400-201, Plano, TX  75024

 

  

          

*A PREMIER SERVICE-DISABLED VETERAN OWNED STAFFING COMPANY*

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