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JOB TITLE: PHARMACY BENEFITS MANAGEMENT PBM SMEand BUSINESS ANALYST
JOB LOCATION: Remote
WAGE RANGE*: 50-60 / hr
JOB NUMBER: 24-00198
REQUIRED EXPERIENCE:
Minimum Qualifications:
EXPERIENCE LEVEL:
PBM SUBJECT MATTER EXPERTISE:
JOB DESCRIPTION
We are looking to onboard a Senior Business Analyst in Manager role or Individual contributor depending on experience level. This person will have deep PBM domain expertise and who will help guide the roadmap and feature enhancements for the Client PBM product suite. This person will serve as a bridge between the Business users and/or Clinical end users (Pharmacists) and the Technical team (Developers and Testers primarily).
Equal Opportunity Employer Veterans/Disabled
* While an hourly range is posted for this position, an eventual hourly rate is determined by a comprehensive salary analysis which considers multiple factors including but not limited to: job-related knowledge, skills and qualifications, education and experience as compared to others in the organization doing substantially similar work, if applicable, and market and BUSINESS considerations. Benefits offered include medical, dental and vision benefits; dependent care flexible spending account; 401(k) plan; voluntary life/short term disability/whole life/term life/accident and critical illness coverage; employee assistance program; sick leave in accordance with regulation. Benefits may be subject to generally applicable eligibility, waiting period, contribution, and other requirements and conditions.
JOB LOCATION: Remote
WAGE RANGE*: 50-60 / hr
JOB NUMBER: 24-00198
REQUIRED EXPERIENCE:
Minimum Qualifications:
EXPERIENCE LEVEL:
- Ideally 10+ years experience working in PBM domain (Claims processing related).
- Willing to consider less experienced candidates who can demonstrate depth in understanding PBM area.
PBM SUBJECT MATTER EXPERTISE:
- Candidate should have deep understanding of Pharmacy Benefit Management (PBM) business processes – including Claims Adjudication, Data related processes (e.g. Eligibility data, Provider data, Drug data, Formulary data, Drug Utilization reviews) and their interconnections. Strong plus if candidate has experience with Electronic Prescriptions and Prior-Authorizations related standards.
- Deep understanding of related PBM standards from NCPDP. Strong plus if candidate also understands CMS regulations related to Medicare & state Medicaid Pharmacy programs.
- Candidate should have deep understanding of Financial Bank (FDB) Drug nomenclature and how to use FDB nomenclature in designing / configuring drug coverage (inclusions/exclusions/PA Criteria) or building Formulary / Preferred Drug Lists. In lieu of FDB, MEDISPAN data experience will be acceptable.
JOB DESCRIPTION
We are looking to onboard a Senior Business Analyst in Manager role or Individual contributor depending on experience level. This person will have deep PBM domain expertise and who will help guide the roadmap and feature enhancements for the Client PBM product suite. This person will serve as a bridge between the Business users and/or Clinical end users (Pharmacists) and the Technical team (Developers and Testers primarily).
Equal Opportunity Employer Veterans/Disabled
* While an hourly range is posted for this position, an eventual hourly rate is determined by a comprehensive salary analysis which considers multiple factors including but not limited to: job-related knowledge, skills and qualifications, education and experience as compared to others in the organization doing substantially similar work, if applicable, and market and BUSINESS considerations. Benefits offered include medical, dental and vision benefits; dependent care flexible spending account; 401(k) plan; voluntary life/short term disability/whole life/term life/accident and critical illness coverage; employee assistance program; sick leave in accordance with regulation. Benefits may be subject to generally applicable eligibility, waiting period, contribution, and other requirements and conditions.
