What are the responsibilities and job description for the Pharmacist – Medicaid Pharmacy Business Analyst position at Tharseo IT?
Description (Revised & Shortened):
Seeking a Pharmacist to serve as a Pharmacy Benefits Management (PBM) Business Integration Specialist supporting a Medicaid Enterprise System project. This role provides subject matter expertise for pharmacy business operations, including clinical policies, prior authorizations, DUR processes, behavioral health programs, preferred drug lists, rebate programs, and physician-administered drugs. The specialist will support PBM module implementation, collaborate with pharmacy business teams, develop business processes and use cases, and assist in user acceptance testing and documentation. Strong knowledge of Medicaid pharmacy benefits, PBM operations, and cross-functional healthcare processes is essential. The role also involves supporting strategic business initiatives, ensuring compliance, and contributing to product lifecycle activities.
Roles & Responsibilities:
- Support key pharmacy business areas: clinical policies, prior authorizations, DUR, lock-in programs, behavioral health, PDL, MDRP, and PADP.
- Assist with cross-functional oversight of Medicaid program activities.
- Collaborate with PBM stakeholders, product managers, and business leads.
- Analyze business needs, recommend improvements, and support implementation of enhancements.
- Provide input to leadership on long-term business solutions.
- Translate business needs into detailed, actionable requirements.
- Ensure compliance with all applicable policies and procedures.
- Support the full product lifecycle from planning to implementation.
- Perform additional duties as assigned.
