What are the responsibilities and job description for the Specialist position at Livemindz?
Hiring: PBM SME (Pharmacy Benefit Management) – Dallas, TX (Hybrid)
We are looking for an experienced PBM (Pharmacy Benefit Management) Subject Matter Expert (SME).
📍 Location: Dallas, TX (Hybrid)
🔹 Key Responsibilities:
- Act as a PBM SME supporting pharmacy benefit operations and business processes
- Work on end-to-end pharmacy claims lifecycle including adjudication and processing
- Handle formulary management, prior authorization (PA), and drug pricing models (AWP, MAC, WAC)
- Collaborate with business and technical teams for requirements gathering and solution design
- Support UAT, issue resolution, and process improvements
🔹 Required Skills:
- Strong experience in Pharmacy Benefit Management (PBM) domain
- Hands-on knowledge of claims processing, eligibility, and benefits configuration
- Understanding of rebates, pricing, and pharmacy workflows
- Experience working with PBM platforms (e.g., RxClaim, Facets, QNXT, etc.)
- Good communication and stakeholder management skills
🔹 Nice to Have:
- SQL / Data analysis experience
- Agile / Scrum exposure
Please share your resume to Monica@she-jobs.com