PBM Business Integration Specialist (Pharmacist)

Overview

Hybrid
Depends on Experience
Contract - W2
Contract - 20 week(s)

Skills

MS Office

Job Details

PBM Business Integration Specialist (Pharmacist)
Primary Location: Raleigh, North Carolina

V-Soft Consulting is currently hiring for a PBM Business Integration Specialist (Pharmacist) for our premier client in Raleigh, North Carolina.

WHAT YOULL NEED:
Technical Requirements and Certifications
  • Registered Pharmacist with a valid (active) and unrestricted Pharmacist license: 3 Years.

Education and Experience
  • Graduation from an accredited School of Pharmacy, B.S. or Doctor of Pharmacy degree.
  • Prior experience with Medicaid applications and preferably across Pharmacy Functional Areas.
  • Preferred to have experience with Medicaid, managed care, and Pharmacy Benefit Manager (PBM) operation areas.
  • Understanding of pharmacy lines of business: retail, long term care, home infusion, mail order, specialty, institutional: 3 Years.
  • Skills to handle multiple priorities and manage communications professionally to achieve issue resolution with customers, employees, or management: 3 Years.
  • Knowledge of the Medicaid Pharmacy (PBM) processes, roles, and intended outcomes: 3 Years.
  • Drug information skills: 3 Years.
  • Experience in ensuring with all applicable policies and procedures.: 3 Years.
  • Demonstrate ability to manage multiple priorities and projects, and function in a fast passed moving constantly changing, deadline-driven environment: 3 Years.
  • Experience handling HIPPA and PII data: 3 Years.
  • Managed care knowledge or experience: 3 Years
  • Medicaid program knowledge or related Healthcare Information experience: 3 Years.
  • Proficient in Microsoft Word, Excel, PowerPoint, Access, and Adobe software: 3 Years.
  • Experience in reviewing and providing feedback and input to senior level decision-makers to develop long-range strategic alternatives for business solutions: 3 Years.
  • Experience working in a combination of business analysis. Product management, project management, and software application development: 3 Years.
  • Excellent communication skills and attention to detail with specific experience developing, editing, and presenting summaries, reports, and complex: 3 Years.

Desired:
  • Knowledge of the Enterprise IT Systems integration principle and associated change management best practices: 1 Year.
  • Proven experience and working knowledge of the agile development methodologies, environment and tools: 2 Years.

WHAT YOULL DO:
Job Responsibilities:
  • 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.
  • 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.
Supports one or more Pharmacy business process areas, including:
  • Clinical policies and Prior Authorizations.
  • Drug Utilization Review (DUR) and pharmacy lock-in related processes.
  • Behavioral health, and A+ kids.
  • Preferred Drug List (PDL) and Medicaid Drug Rebate Program (MDRP).
  • Physicians Administered Drug Program (PADP) related to the Medicaid Drug Rebate Program (MDRP).

Interested?
Qualified candidates should send their resumes to skhatun@vsoftconsulting.com

V-Soft Consulting Group is recognized among the top 100 fastest growing staffing companies in North America, V-Soft Consulting Group is headquartered in Louisville, KY with strategic locations in India, Canada and the U.S. V-Soft is known as an agile, innovative technology services company holding several awards and distinctions and has a wide variety of partnerships across diverse technology stacks.

As a valued V-Soft Consultant, youre eligible for full benefits (Medical, Dental, Vision), a 401(k) plan, competitive compensation and more. V-Soft is partnered with numerous Fortune 500 companies, exceptionally positioned to advance your career growth.

V-Soft Consulting provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

For more information or to view all our open jobs, please visit www.vsoftconsulting.com or call (844) 425-8425.

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