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Jobs or company...
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PBM Business Integration Specialist

  • Full Time, onsite
  • UniMind Software Solutions,Inc
  • Hybrid, United States of America
Salary undisclosed

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Dice
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Simplified

PBM Business Integration Specialist
Raleigh, NC Hybrid

12 Months

Webcam Interview Only

Our client is seeking a Pharmacist as a Pharmacy Benefits Management (PBM) Business Integration Specialist

The Pharmacy team needs a Business Integration Specialist who is dedicated to the PBM Module Implementation and can focus on these work streams as they relate to implementation of the new PBM, in collaboration with the existing pharmacy team.


Responsibilities

Supports one or more Pharmacy business process areas, including.

o Clinical policies and Prior Authorizations.

o Drug Utilization Review (DUR) and pharmacy lock-in related processes

o Behavioral health, and A+ kids.

o Preferred Drug List (PDL) and Medicaid Drug Rebate Program (MDRP)

o Physicians Administered Drug Program (PADP) related to the Medicaid Drug Rebate Program (MDRP)

Supports cross-functional activities that provide effective oversight of Medicaid Programs.

Collaborates and communicates with the PBM Business stakeholders (Product Managers, Product Owners, Business Leads.)

In-depth knowledge and understanding of the business needs across functions and business segments in healthcare that meet departmental goals.

Ability to research and recommend the development and implementation of business initiatives of the product enhancements.

Provides feedback and input to senior level decision-makers to develop long-range strategic alternatives for business solutions.

Preferred to have experience with Medicaid, managed care, and Pharmacy Benefit Manager (PBM) operations. areas.

Prior experience with Medicaid applications and preferably across Pharmacy Functional Areas.

Communicate with the business owner needs and help translate them into detailed and actionable requirements as needed.

Ensures compliance with all applicable policies and procedures.

Supporting the product lifecycle from conception through implementation.

Performs other duties as assigned.

Employers have access to artificial intelligence language tools (“AI”) that help generate and enhance job descriptions and AI may have been used to create this description. The position description has been reviewed for accuracy and Dice believes it to correctly reflect the job opportunity.
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