Job Description

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 degree
• Registered Pharmacist with a valid (active) and unrestricted Pharmacist license
• Licensed to practice pharmacy in the State of North Carolina or the ability to receive the North Carolina license to practice Pharmacy within 90 days
• Understanding of pharmacy lines of business: retail, long term care, home infusion, mail order, specialty, institutional
• Skills to handle multiple priorities and manage communications professionally to achieve issue resolution with customers, employees, or management
• Knowledge of the Medicaid Pharmacy (PBM) processes, roles, and intended outcomes
• Drug information skills
• Experience 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 environment
• Proficient in Microsoft Word, Excel, PowerPoint, Access, and Adobe software
• Experience in reviewing and providing feedback and input to senior level decision-makers to develop long-range strategic alternatives for business sol
• Experience working in a combination of business analysis. Product management, project management, and or software application development
• Experience handling HIPPA and PII data
• Managed care knowledge or experience
• Medicaid program knowledge or related Healthcare Information experience
  
  

V 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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