For more details, please connect with Shweta Patel email her at Shwetap@vgroupinc.com
Direct Client : State of North Carolina
Job Title : Business Integration Specialist
Duration : 05 + Months
Start Date : Asap
Location : Raleigh, NC - 27607 (Hybrid)
Position Type : Contract
Interview Type : Inperson / WebCam
Ceipal ID : SNC_BIS543_SP
Requirement ID : (766543)
Description : Pharmacy Business Integration Specialist is responsible in supporting the Business Management space to achieve successful development of the Pharmacy Benefit Management Solution in support of the Medicaid program. The Business Integration Specialist will work collaboratively with the Business owner and the rest of the business team to develop the strategy behind how each MES module will support the business requirements definition as well translation and specification of all functional requirements
Key Responsibilities :
- 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)
- 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
Required Qualifications :
Graduation from an accredited School of Pharmacy, B.S. or Doctor of Pharmacy degreeRegistered Pharmacist with a valid (active) and unrestricted Pharmacist licenseLicensed to practice pharmacy in the State of North Carolina or the ability to receive the North Carolina license to practice Pharmacy within 90 daysUnderstanding of pharmacy lines of business : retail, long term care, home infusion, mail order, specialty, institutionalSkills to handle multiple priorities and manage communications professionally to achieve issue resolution with customers, employees, or managementKnowledge of the Medicaid Pharmacy (PBM) processes, roles, and intended outcomesDrug information skillsExperience in ensuring with all applicable policies and procedures.Demonstrate ability to manage multiple priorities and projects, and function in a fast passed moving constantly changing, deadline-driven environmentProficient in Microsoft Word, Excel, PowerPoint, Access, and Adobe softwareExperience in reviewing and providing feedback and input to senior level decision-makers to develop long-range strategic alternatives for business solExperience working in a combination of business analysis. Product management, project management, and or software application developmentExperience handling HIPPA and PII dataManaged care knowledge or experienceMedicaid program knowledge or related Healthcare Information experienceV Group Inc. is an IT Services company that supplies IT staffing, project management, and delivery services in software, network, help desk, and all IT areas. Our primary focus is the public sector including state and federal contracts. We have multiple awards / contracts with the following states : CA, FL, GA, MD, MI, NC, NY, OH, OR, PA, SC, VA, and WA, CT, TN. If you are considering applying for a position with V Group or partnering with us on a position, please feel free to contact me with any questions you may have regarding our services and the advantages we can offer you as a consultant.
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