Pharmacist

Zolon Tech Inc.; Raleigh (NC); Hybrid; USD 98,000 - 172,000; Full time

Job summary

Zolon Tech Inc. is seeking a dedicated Business Integration Specialist for their Pharmacy team, focusing on the implementation of the PBM Module. This role requires an RN license from NC and encompasses various responsibilities, including supporting Medicaid programs and collaborating with stakeholders to meet departmental goals. Ideal candidates will have experience in Medicaid and managed care operations, with strong communication and analytical skills.

Qualifications

• Dedicated to the PBM Module implementation.
• Prior experience with Medicaid applications.
• Ability to research and recommend improvements.

Responsibilities

• Support Pharmacy business process areas.
• Collaborate with PBM Business stakeholders.
• Ensure compliance with policies and procedures.

Skills

Medicaid knowledge

Pharmacy Benefit Manager (PBM) operations

Clinical policies

Communication

Business analysis

Education

RN license from NC

Job description

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• This posting is preferred as Hybrid but remote is available.
• Required RN license from NC.
• The Pharmacy team needs a Business Integration Specialist who is dedicated to the PBM Module Implementation and can focus on these work streams as they relate to implementation of the new PBM, in collaboration with the existing pharmacy team.
• Roles and Responsibilities
• Supports one or more Pharmacy business process areas, including.
• oClinical policies and Prior Authorizations.
• oDrug Utilization Review (DUR) and pharmacy lock-in related processes
• oBehavioral health, and A+ kids.
• oPreferred Drug List (PDL) and Medicaid Drug Rebate Program (MDRP)
• oPhysicians 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.

Seniority level

• Seniority level

  Associate

Employment type

• Employment type

  Contract

Job function

• Job function

  Health Care Provider

• Industries

  Manufacturing

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