NCDHHS-HB PBM Business Integration Specialist (Pharmacist)
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Job Location:
Raleigh, WV - USA
Monthly Salary:
Not Disclosed
Posted on:
30+ days ago
Vacancies:
1 Vacancy
Job Summary
Job Summary:
The PBM Business Integration Specialist (Pharmacist) will serve as a subject matter expert within the Pharmacy Business space supporting the development and implementation of a Medicaid Enterprise Modular Pharmacy Business Management (PBM) Solution. This role involves collaborating with stakeholders defining business requirements and ensuring compliance with policies and procedures related to Medicaid pharmacy benefits.
The PBM Business Integration Specialist (Pharmacist) will serve as a subject matter expert within the Pharmacy Business space supporting the development and implementation of a Medicaid Enterprise Modular Pharmacy Business Management (PBM) Solution. This role involves collaborating with stakeholders defining business requirements and ensuring compliance with policies and procedures related to Medicaid pharmacy benefits.
Location:Raleigh North Carolina United StatesnWashington District of Columbia United States
Responsibilities:
- Supports pharmacy business process areas including clinical policies prior authorizations drug utilization review pharmacy lock-in behavioral health programs preferred drug lists and physician-administered drug programs.
- Supports cross-functional activities for effective oversight of Medicaid Programs.
- Collaborates and communicates with PBM Business stakeholders.
- Researches and recommends the development and implementation of business initiatives and product enhancements.
- Provides feedback to senior-level decision-makers for strategic business solutions.
- Translates business owner needs into detailed and actionable requirements.
- Ensures compliance with all applicable policies and procedures.
- Supports the product lifecycle from conception through implementation.
- Performs other duties as assigned.
- Develops business process documents use cases scenarios and user acceptance test cases.
- Supports pharmacy business process areas including clinical policies prior authorizations drug utilization review pharmacy lock-in behavioral health programs preferred drug lists and physician-administered drug programs.
- Supports cross-functional activities for effective oversight of Medicaid Programs.
- Collaborates and communicates with PBM Business stakeholders.
- Researches and recommends the development and implementation of business initiatives and product enhancements.
- Provides feedback to senior-level decision-makers for strategic business solutions.
- Translates business owner needs into detailed and actionable requirements.
- Ensures compliance with all applicable policies and procedures.
- Supports the product lifecycle from conception through implementation.
- Performs other duties as assigned.
- Develops business process documents use cases scenarios and user acceptance test cases.
Required Skills & Certifications:
Preferred Skills & Certifications:
Special Considerations:
Scheduling:
Key Skills
- LTC Pharmacy
- Hospital Experience
- Pharmacy Software
- Continuous Improvement
- Go
- Infusion Experience
- Pharmacy Residency
- Training & Development
- Order Entry
- Epic
- Clinical Pharmacy Experience
- Compounding Medications
