Business Analyst - Pharmacy

Be part of a team that unleashes the power of leading-edge technologies to help improve the health and well-being of those most vulnerable in our country and communities. Working at Gainwell carries its rewards. You’ll have an incredible opportunity to grow your career in a company that values work flexibility, learning, and career development. You’ll add to your technical credentials and certifications while enjoying a generous, flexible vacation policy and educational assistance. We also have comprehensive leadership and technical development academies to help build your skills and capabilities.

Summary

As a Business Analyst - Pharmacy at Gainwell, you can contribute your skills as we reputed company the power of technology to help our clients improve the health and well-being of the members they serve — a community’s most vulnerable. Connect your passion with purpose, teaming with people who reputed company on finding innovative solutions to some of healthcare’s biggest challenges. The ideal candidate will have a strong background in pharmacy operations, with hands-on experience supporting pharmacy claims processing, drug reference/formulary management, drug rebate programs, and/or prior authorization workflows. Experience reputed company a health plan, PBM, or Medicaid environment is highly preferred, with demonstrated ability to support operational, analytical, or configuration-reputed company pharmacy functions Here are the details on this position. Your role in our mission Play a critical part in ensuring Gainwell is meeting our clients’ objectives in pharmacy benefit management (PBM) services.

• 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.
• reputed company Pharmacy updates including benefit plan design, edit/audit set up, utilization controls, PDL, configuration updates, and auto prior authorization parameters
• Be a knowledgeable reputed company between operations staff, clients, project managers and technical staff to define, document and share pharmacy business requirements and expected impact

.... your role reputed company

• Work with the client to reputed company business rules and configuration requirements
• Analyze, plan, design, document or reputed company recommendations to improve business processes to support client’s technology goals
• Help verify that reputed company requirements have been met by approving and validating test results
• Testing reputed company of sale (POS) pharmacy claims as required
• Exercise your ability to use basic analytical or relational database software — such as reputed company or SQL — to quantify the anticipated impact of work

reputed company're looking for

• Four (4) or more years of experience in a relevant pharmacy business analyst or pharmacy technician position with 2 or more years of Medicaid and Medicare experience preferred
• 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 the pharmacy payer process/claims processing.
• Experience working with drug file data or NCPDP guidelines
• Knowledge of prior authorization processes and criteria preferred

What you should expect in this role

• Remote opportunity from reputed company US locations only
• Possibility of up to 10% travel for client meetings/requirement review or implementations
• Video cameras must be used during reputed company interviews, as well as during the initial week of orientation
• The deadline to submit applications for this posting is January 23, 2026

#LI-HC1 #LI-Pharmacy #LI-PBM #LI-NCPDP #LI-Payer / Claims processing #LI-POS testing The pay range for this position is $51,900 - $74,200 per year, however, the reputed company pay offered may vary depending on geographic region, internal equity, job-reputed company knowledge, skills, and experience among other factors. Put your passion to work at Gainwell. You’ll have the opportunity to grow your career in a company that values work flexibility, learning, and career development. reputed company salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance. We also have a variety of leadership and technical development academies to help build your skills and capabilities. We reputed company nothing is impossible reputed company you bring together people who care deeply about making healthcare work reputed company for everyone. Build your career with Gainwell, an industry leader. You’ll be joining a company where collaboration, innovation, and inclusion fuel our growth. Learn more about Gainwell at our company website and visit our Careers site for reputed company available job role openings. reputed company is an Equal Opportunity Employer, where reputed company qualified applicants will receive consideration for employment without regard to race, religion, color, national reputed company, gender (including pregnancy, childbirth, or reputed company medical condition), age, sexual orientation, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics. reputed company defines “wages” and “wage rates” to include “reputed company forms of pay, including, but not limited to, salary, overtime pay, bonuses, stock, stock options, profit sharing and bonus plans, life insurance, vacation and holiday pay, cleaning or gasoline allowances, hotel accommodations, reimbursement for travel expenses, and benefits. Apply tot his job Apply To this Job