Overview
On Site
Depends on Experience
Contract - W2
Contract - 06 Month(s)
No Travel Required
Skills
Communication
Acceptance Testing
Analytics
Benefits Management
Business Process
Collaboration
Documentation
FOCUS
Healthcare Information Technology
Legal
MES
Medicaid
Onboarding
Pharmacy
Procurement
Use Cases
Job Details
Job Title: PBM Business Integration Specialist (Pharmacist)
Job ID: 25-08872
Location: Raleigh, NC
Duration: 06 Months On Contract
Job Summary:
Client seeks a Pharmacist to serve as a Pharmacy Benefits Management (PBM) Business Integration Specialist for its Medicaid Enterprise System (MES) program. This role will focus on supporting the implementation of a modular PBM solution, working closely with internal Pharmacy teams and the PBM vendor.
Key Responsibilities:
Requirements:
Job ID: 25-08872
Location: Raleigh, NC
Duration: 06 Months On Contract
Job Summary:
Client seeks a Pharmacist to serve as a Pharmacy Benefits Management (PBM) Business Integration Specialist for its Medicaid Enterprise System (MES) program. This role will focus on supporting the implementation of a modular PBM solution, working closely with internal Pharmacy teams and the PBM vendor.
Key Responsibilities:
- Act as SME for Clinical policies, Prior Authorizations, DUR, Behavioral Health, PDL, MDRP, and PADP.
- Collaborate with Pharmacy Business Unit and vendors during PBM onboarding and implementation.
- Support business process documentation, use cases, UAT scenarios, and strategic initiatives.
- Coordinate with cross-functional teams: Analytics, IT, Legal, Procurement, etc.
- Ensure alignment with Medicaid regulations and business goals.
Requirements:
- Experience in Medicaid Pharmacy Benefits Management or PBM operations.
- Knowledge of Medicaid drug programs (PDL, DUR, MDRP, etc.).
- Strong communication and stakeholder collaboration skills.
- Preferably has experience in managed care and healthcare IT systems.
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