Senior Business Analyst, Government Programs Operations

Location: Hybrid (Local to NYC area)Position SummaryThe Senior Business Analyst, Government Programs Operations provides support gathering and documenting business and reporting requirements that align with state and federal guidelines. This individual will analyze complex problems and issues using available information from both internal and external sources. Other responsibilities will include – creating specifications documents for business processes, reports, data extracts, and analyses based on business needs. Identify and interpret trends in datasets to find possible outliers or patterns that can be used to drive process improvements. Collaborates with internal and external cross-functional teams (compliance, product, sales, marketing, underwriting, implementation, client services, clinical operations) to design, refine, automate, and maintain operational capabilities.Position Responsibilities• Monitors for changes in existing business processes and updates documentation accordingly - Finds new opportunities for process developments and improvements• Intake, analyze and manage requests from stakeholders• Proactively reviews business processes and data to develop subject matter expertise of processes supported by our team• Drives root-cause-analysis and resolution of data and processes issues/errors by partnering with key stakeholders• Supports analytical, problem-solving functions by defining and documenting specifications pertinent to all departmental processes• Analyzes business workflow and system needs for conversions and migrations to ensure that encounter, recovery, and cost savings regulations are met• Prepares end user documentation and training materials as needed• Support encounter and PDE (Prescription Drug Events) submission process by analyzing complex data issues using data from internal and external sources• Develop and set up performance metrics for stakeholder distribution• Performs root cause analysis of claims/encounters processing and submission issues; develops recommendations based on data and industry knowledgeMinimum Qualifications• 3+ years of healthcare experience• 3+ years of business process analysis, preferably in healthcare• Demonstratable knowledge of SQL, Excel, and other data visualization tools• Experience with implementation/project management• Experience working with cross-functional teams• Extremely flexible, highly organized, excellent communication and able to shift priorities easily• Attention to detail & commitment to delivering high-quality work product• Comfort or experience in a fast-paced, growing environment• Intellectual and professional curiosity• Familiarity with the agile framework/Certified Scrum Product Owner preferred• Demonstratable knowledge of the Python programming language preferred• Experience with Medicare, Medicaid, and Government Exchange programs preferredBase Salary: $90,000 - $100,000Nothing in this position description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.About Capital RxCapital Rx is a full-service pharmacy benefit manager (PBM) and pharmacy benefit administrator (PBA), advancing our nation’s electronic healthcare infrastructure to improve drug price visibility and patient outcomes. As a Certified B Corp™, Capital Rx is executing its mission through the deployment of JUDI®, the company’s cloud-native enterprise health platform, and a Single-Ledger Model™, which increases visibility and reduces variability in drug prices. JUDI connects every aspect of the pharmacy ecosystem in one efficient, scalable platform, servicing millions of members for Medicare, Medicaid, and commercial plans. Together with its clients, Capital Rx is reimagining the administration of pharmacy benefits and rebuilding trust in healthcare.Capital Rx values a diverse workplace and celebrates the diversity that each employee brings to the table. We are proud to provide equal employment opportunities to all employees and applicants for employment and prohibit discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, medical condition, genetic information, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.