Business Analyst (NCPDP) - Remote

We are a unique and innovative retail risk management and employee benefits insurance brokerage and consulting firm, founded in San Francisco, California in 2007 with offices and leadership across the country.

EPIC Insurance Brokers & Consultants has a depth of industry expertise across key lines of insurance, including risk management, property and casualty, employee benefits, unique specialty program insurance and private client services.

EPIC team members have consistently recognized their company as a 'Best Place to Work' in multiple regions and as a 'Best Place to Work in the Insurance Industry' nationally.

Job Description:

The Business Solutions Analyst is a client-facing consultant who supports health plans, pharmacy benefit managers (PBMs), and other healthcare organizations through complex business and technology initiatives. Because PSG provides BA services through varied client statements of work, this role must adapt quickly across projects, delivery models, tools, and levels of detail. Depending on the engagement, the Business Solutions Analyst may support strategy, operational requirements, technical requirements, RFP evaluation, regulatory readiness, product-related work, or implementation activities such as health plan PBM migrations. The successful candidate can operate strategically with client leaders and also work in the details of workflows, files, requirements, testing, risks, and implementation decisions.

Responsibilities:

• Lead discovery and analysis by asking probing questions, clarifying problems, challenging assumptions, and identifying missing information, risks, dependencies, and operational impacts.
• Translate business and operational needs into clear business, functional, data, and technical requirements at the level required by the engagement.
• Analyze current-state and future-state processes, systems, files, data exchanges, controls, and handoffs; document gaps and practical recommendations.
• Serve as a liaison among clients, health plans, PBMs, vendors, operational teams, technical teams, and project leadership to align scope, requirements, decisions, and expectations.
• Adapt BA methods and deliverables to each client and statement of work, including strategic assessments, operational transformation, regulatory initiatives, product-related support, PBM procurement, and implementation or migration programs.
• Support RFP development and evaluation by reviewing requirements and vendor responses, applying scoring criteria, documenting rationale, identifying gaps, and supporting consensus discussions.
• Facilitate client, vendor, and internal working sessions; capture decisions and actions; and drive follow-up to completion.
• Support testing and readiness activities, including test planning, test case development, traceability, defect review, evidence validation, implementation planning, go/no-go support, and stabilization.
• Create concise, client-ready deliverables that synthesize findings, options, implications, and recommendations for both executive and delivery audiences.
• Own assigned workstreams and deliverables, manage priorities and documentation, escal…
• Perform other duties as assigned.

Qualifications:

• 5+ years of business analysis, consulting, implementation, or transformation experience in healthcare, including client-facing work.
• Meaningful, hands-on experience with both health plan operations and PBM operations is required. General healthcare experience alone does not meet this requirement.
• Strong knowledge of pharmacy benefit operations and the pharmacy claims lifecycle, including areas such as eligibility, benefit configuration, accumulators, formulary, utilization management, prior authorization, member services, reporting, and vendor interfaces.
• Experience supporting multiple engagement types, such as PBM implementations or migrations, health plan transformation, strategic assessments, regulatory programs, product-related initiatives, vendor selection, RFP evaluation, testing, or operational readiness.
• Experience developing and managing business, operational, functional, data, or technical requirements and supporting traceability through testing and implementation.
• Bachelor’s degree or equivalent relevant experience required.
• Knowledge of NCPDP standards, government programs, pharmacy transaction processing, or major regulatory transitions preferred.
• Experience with Jira, Azure DevOps, process-mapping tools, and advanced Microsoft Excel and PowerPoint preferred.

Skills & Abilities:

• Strong critical thinking and structured problem-solving skills, including the ability to evaluate incomplete or conflicting information and reach defensible conclusions.
• Intellectual curiosity and investigative thinking, with a demonstrated ability to ask effective follow-up questions, uncover root causes, and understand downstream impacts.
• Ability to move comfortably between strategic discussions and detailed analysis without losing the connection between business outcomes, operations, and technology.
• Consulting agility and learning agility, with the ability to transition quickly across clients, subject areas, delivery approaches, and project types with limited ramp-up time.
• Strong facilitation, written communication, presentation, and stakeholder management skills with technical and non-technical audiences.
• Ability to translate complex technical information into clear operational and client-facing language, and operational needs into actionable requirements.
• High degree of ownership, sound judgment, attention to detail, and ability to move work forward independently in ambiguous environments.
• Ability to work within Agile, Waterfall, hybrid, or client-specific methodologies and use tools such as Jira or Azure DevOps when required by the engagement.