Senior Analyst Pharmacy (PBM)

Job Description

Must Have Technical/Functional Skills

We are seeking an experienced Senior Analyst with strong expertise in the Pharmacy Benefit Management (PBM) domain. The candidate will play a critical role in analyzing pharmacy benefit workflows, gathering business requirements, and supporting end-to-end delivery pharmacy solutions.

Required Skills & Experience(8 Years)

• Strong expertise in Pharmacy Benefit Management (PBM) processes:

Pharmacy claims adjudication

Formulary and drug benefits

Prior authorization workflows

Membership, enrollment, and billing

• Strong background in:

Requirement gathering and documentation

Agile methodologies

Stakeholder communication

• Good understanding of HIPAA compliance.

Preferred Skills

• Experience with PBM platforms and pharmacy ecosystems.
• Exposure to:
• Drug claims processing and adjudication
• Pharmacy networks and pricing
• Medicare / Commercial health plans
• Knowledge of tools:

JIRA / Rally / ALM

SQL for data validation

Salary Range: $100,000- $140,000 a year

TCS Employee Benefits Summary

Discretionary Annual Incentive.

Comprehensive Medical Coverage: Medical & Health, Dental & Vision, Disability Planning & Insurance, Pet Insurance Plans.

Family Support: Maternal & Parental Leaves.

Insurance Options: Auto & Home Insurance, Identity Theft Protection.

Convenience & Professional Growth: Commuter Benefits & Certification & amp; Training Reimbursement.

Time Off: Vacation, Time Off, Sick Leave & Holidays.

Legal & Financial Assistance: Legal Assistance, 401K Plan, Performance Bonus, College Fund, Student Loan Refinancing.

Qualifications: BACHELOR OF COMPUTER SCIENCE