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POSITION SUMMARY:

Under the direction of the Pharmacy Program Manager or designee, the Pharmacy Business System Analyst is responsible for compiling, translating, testing and reporting on the business and clinical requirements of the Massachusetts Medicaid  (“MassHealth”) Pharmacy Program’s Pharmacy On-line Processing System (POPS) solution.  These business and clinical requirements are then translated into functional requirements for use in the development, enhancement, and modification of the various applications that comprise the POPS.   

The Pharmacy Business System Analyst acts as both an independent contributor and part of a team.  This role requires strong communication and collaboration skills as there will be extensive interaction within the MassHealth agency.  Additionally, the Pharmacy Business System Analyst is hands-on with pharmacy claims data, including the ability to write and run queries to help support data-driven decision making and the creation of dashboard reporting.  Finally, this role may independently identify enhancement opportunities for process changes and present those data and/or process changes to teams working with MassHealth, including at the executive level.

ESSENTIAL FUNCTIONS:

• Participate in and contribute to the needs assessment and system requirement identification for the POPS solution through technical and functional consultation.
• Facilitate discussions regarding enhancements and solutions for the POPS.
• Collaborate on the development of functional specifications with other organizations with a relationship to POPS or the pharmacy program, including but not limited to the POPS Vendor, EOHHS, UMASS, and Managed Care Entities.
• Develop functional specifications documents for POPS.
• Ensure ongoing accuracy of systems documentation.
• Develop and execute test plans and test cases that comprehensively test software changes.
• Participate in POPS user acceptance testing activities.
• Develop assessments of the cost/benefit and feasibility of software changes and make recommendations of best alternatives.
• Monitor the schedule of deliverables against the program’s priorities and timelines, including communicating delays and schedule changes to the POPS Program Manager.
• Monitor and review data exchanges between POPS and other organizations including but not limited to EOHHS, UMASS, Managed Care Entities, and various contracted entities.
• Establish and maintain communications between the various entities that comprise the pharmacy program and within EOHHS as directed, including but not limited to the POPS Vendor, UMMS IT, EOHHS, and Managed Care Entities.
• Communicate with stakeholders regarding timelines for changes and enhancements to POPS system.
• Participate in annual POPS Disaster Recovery exercises.
• Assist EOHHS and UMASS with ad hoc requests and/or reporting by:
• identifying opportunities to turn ad-hoc reports into self-service dashboards of recurring reports 
• supporting, in-taking, managing and resolving issues identified with external/internal data
• Assist EOHHS and UMASS with the assessment of and/or procurement of related system applications and enhancements to applications.
• Performs other related duties as assigned.

REQUIRED QUALIFICATIONS:

• Bachelor’s degree in Computer Science, Information Systems Management, or equivalent experience.
• 5 years of related experience, including some project management experience.
• Excellent oral and written communication skills.
• Demonstrated ability to work in complex environment.
• Demonstrated strong problem-solving skills with an ability to take ownership of tasks.
• Demonstrated innovation, flexibility, and creativity.
• Ability to travel to off-site locations.

PREFERRED QUALIFICATIONS:

• Experience working on IT projects, including in a claim adjudication environment.
• Demonstrated understanding of data warehousing and data reconciliation.
• Experience working with federal and state agencies preferred.

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