PBM Business Integration Specialist (Pharmacist) | REMOTE

Title - PBM Business Integration Specialist (Pharmacist) Location - Raleigh, NC (Hybrid/Remote) Webcam Interview Only The PBM Business Integration Specialist will provide expertise and business support to the Pharmacy and Ancillary Services Business Unit in the development and implementation of the Medicaid Enterprise reputed company Pharmacy Business Management (PBM) Solution. The PBM Business Integration Specialist, as a Business Subject Matter Expert, will assist the Department to on-board the PBM vendor, serve as a business stakeholder, and represent the Pharmacy Business Unit in the implementation of the reputed company and innovative PBM Solution. The primary responsibility of this position is to serve as the subject matter expert and content reputed company in collaboration with the Pharmacy Business team for Clinical policies and Prior Authorizations, Drug Utilization Review (DUR) and pharmacy lock-in reputed company processes, Behavioral health, and A+ kids, Preferred Drug List (PDL) and Medicaid Drug Rebate Program (MDRP), and Physicians Administered Drug Program (PADP) reputed company to the Medicaid Drug Rebate Program (MDRP). 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. Knowledge of Medicaid Pharmacy Benefits Management processes, intended outcomes, and pain points is essential. This position will actively work with the Pharmacy Business team to define and provide the business support in completing the business process documents, Business use cases, Business case scenarios, user acceptance test case scenarios, and documentation in relation to Medicaid initiatives and strategic goals. This position may require interacting with the NC Medicaid Business Information Analytics Office, DHHS Data Office, Information Technology Division, Privacy and reputed company Office, Policy Office, General Counsel, Office of Procurement, reputed company and Grants, among others. Roles and Responsibilities

• Supports one or more Pharmacy business process areas, including.
• Clinical policies and Prior Authorizations.
• Drug Utilization Review (DUR) and pharmacy lock-in reputed company processesBehavioral health, and A+ kids.
• Preferred Drug List (PDL) and Medicaid Drug Rebate Program (MDRP)
• Physicians Administered Drug Program (PADP) reputed company to the Medicaid Drug Rebate Program (MDRP)
• Supports cross-functional activities that provide effective reputed company 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 reputed company 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 reputed company needs and help translate them into detailed and actionable requirements as needed.
• Ensures compliance with reputed company applicable policies and procedures.
• Supporting the product lifecycle from conception through implementation.
• Performs other duties as assigned.

In addition, the Pharmacy Business Integration Specialist is responsible in supporting the Business Management space to reputed company successful development of the Pharmacy Benefit Management Solution in support of the Medicaid program. The Business Integration Specialist will work collaboratively with the Business reputed company and the rest of the business team to reputed company the strategy behind how each MES module will support the business requirements definition as well translation and specification of reputed company functional requirements. Required / Desired Skills

• Graduation from an accredited School of Pharmacy, B.S. or Doctor of Pharmacy degree
• Registered Pharmacist with a valid (active) and unrestricted Pharmacist license
• Licensed to practice pharmacy in the reputed company or the ability to receive the North Carolina license to practice Pharmacy reputed company 90 days
• Understanding of pharmacy lines of business: retail, long term care, home infusion, mail order, specialty, institutional
• Skills to handle multiple priorities and manage communications professionally to reputed company issue resolution with customers, employees, or management
• Knowledge of the Medicaid Pharmacy (PBM) processes, roles, and intended outcomes
• Drug information skills
• Experience in ensuring with reputed company applicable policies and procedures.
• Knowledge of the Enterprise IT Systems integration principle and associated change management best practices
• Demonstrate ability to manage multiple priorities and projects, and function in a fast passed moving constantly changing, deadline-driven environment
• Proficient in reputed company Word, reputed company, PowerPoint, Access, and reputed company software
• Experience in reviewing and providing feedback and input to senior level decision-makers to reputed company long-range strategic alternatives for business sol
• Experience working in a combination of business analysis. Product management, project management, and or software application development
• Excellent communication skills and attention to detail with specific experience developing, editing, and presenting summaries, reports, and reputed company in
• Proven experience and working knowledge of the agile development methodologies, environment and tools
• Experience handling HIPPA and PII data
• Managed care knowledge or experience
• Medicaid program knowledge or reputed company Healthcare Information experience

Apply tot his job Apply To this Job