Background in Healthcare, preferably Pharmacist or Pharmacy background
Prior Auth skills preferred,
Prior IT Skills preferred
Hands on experience with Excel, Creating Mapping(criteria), coding rules engine etc.
Case review
Traversing thru Decision Tree, moving to End point, QA for results.
The position works closely with other business teams to manage scheduled and ad hoc projects for new implementation and maintenance of existing clients. There are cross-functional responsibilities to support other departments.
Candidate Profile
Education qualification: B Pharma or D Pharma
2+ years of experience in implementing PBM schema, with hands on experience in healthcare domain.
Strong verbal and business communication skills- (Must have)
Skill in identifying data issues and anomalies during analysis
US hour overlapping.
Change agile; willing and able to adjust individual and team direction based upon changing priorities and business need
Ability to think critically, problem solve and make decisions while anticipating the broad impact of decisions
Familiar with state and federal pharmaceutical regulations preferred
