PBM Business Integration Specialist (Pharmacist)

Job Title: PBM Business Integration Specialist

Job Id: 24-04987

Location: Raleigh, NC (Hybrid)

Duration: 01 Months On Contract

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 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.