Senior Business Analyst – Pharmacy (RCM, Billing & Financial Reconciliation)

<div class="content-intro"><p>Inovalon was founded in 1998 on the belief that technology, and data specifically, would empower the transformation of the entire healthcare ecosystem for the better, improving both outcomes and economics. At Inovalon, we believe that when our customers are successful in their missions, healthcare improves. Therefore, we focus on empowering them with data-driven solutions. And the momentum is building.</p> <p>Together, as ONE Inovalon, we are a united force delivering solutions that address healthcare’s greatest needs. Through our mission-based culture of inclusion and innovation, our organization brings value not just to our customers, but to the millions of patients and members they serve.</p></div><p><strong>Overview</strong></p> <p>We are seeking a highly experienced Senior Business Analyst with deep expertise in <strong>specialty/infusion pharmacy, medical billing, and financial reconciliation</strong>&nbsp;to support enterprise SaaS implementations. This role serves as a critical liaison between clients, operations, product, and engineering teams to define business requirements, design future-state workflows, and ensure successful delivery of Revenue Cycle Management (RCM) solutions.</p> <p>The ideal candidate brings strong domain knowledge in <strong>pharmacy billing, claims adjudication, payment posting, and reconciliation</strong>, and plays a key role across the full client lifecycle—from pre-sales through implementation and post-go-live optimization.</p> <p><strong>Key Responsibilities</strong></p> <p><strong>Delivery &amp; Strategic Execution</strong></p> <ul> <li>Lead complex and enterprise-wide implementations with multiple integrated workstreams</li> <li>Own RCM functional track deliverables, ensuring alignment across stakeholders</li> <li>Define governance standards, implementation plans, and risk mitigation strategies</li> <li>Drive future-state workflow design across pharmacy operations and revenue cycle processes</li> <li>Manage release coordination, dependencies, and cross-functional execution</li> </ul> <p><strong>Pharmacy Billing &amp; Revenue Cycle Expertise</strong></p> <ul> <li>Serve as Subject Matter Expert (SME) in:</li> <ul> <li>Medical and pharmacy billing (specialty and infusion)</li> <li>Claims lifecycle management (submission, adjudication, reversals, rebilling)</li> <li>Payment posting, ERA (835), and financial reconciliation</li> </ul> <li>Optimize workflows to improve:</li> <ul> <li>Clean claim rate and first-pass yield</li> <li>Denial management and resolution</li> <li>Days in Accounts Receivable (A/R