Network Engineer

3 weeks ago

Raleigh, United States Crescens Full time

Job Title :

PBM Business Integration Specialist Location:

Raleigh, NC Duration: 12+ months Type: Contract

Job Description:

The PBM Business Integration Specialist will serve as a member of the Medicaid Enterprise System (MES) Program within Pharmacy Business space. The PBM Business Integration Specialist will provide expertise and business support to the Pharmacy and Ancillary Services Business Unit in the development and implementation of the Medicaid Enterprise Modular Pharmacy Business Management (PBM) Solution. The PBM Business Integration Specialist, as a Business Subject Matter Expert, will assist the Department to on-board the PBM vendor, serve as a business stakeholder, and represent the Pharmacy Business Unit in the implementation of the complex and innovative PBM Solution. The primary responsibility of this position is to serve as the subject matter expert and content lead in collaboration with the Pharmacy Business team for Clinical policies and Prior Authorizations, Drug Utilization Review (DUR) and pharmacy lockin related processes, Behavioral health, and A+ kids, Preferred Drug List (PDL) and Medicaid Drug Rebate Program (MDRP), and Physicians Administered Drug Program (PADP) related to the Medicaid Drug Rebate Program (MDRP). 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. Knowledge of Medicaid Pharmacy Benefits Management processes, intended outcomes, and pain points is essential. This position will actively work with the Pharmacy Business team to define and provide the business support in completing the business process documents, Business use cases, Business case scenarios, user acceptance test case scenarios, and documentation in relation to Medicaid initiatives and strategic goals. This position may require interacting with the NC Medicaid Business Information Analytics Office, client Data Office, Information Technology Division, Privacy and Security Office, Policy Office, General Counsel, Office of Procurement, Contracts and Grants, among others.

Roles and 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+ kid. 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, and 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. In addition, the 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.

Education and Experience (Required):

Graduation from an accredited School of Pharmacy B.S. or Doctor of Pharmacy degree required. Registered Pharmacist with a valid and unrestricted Pharmacist license 3+ years of professional experience, preferably within a Medicaid agency or Pharmacy Benefit Manager (PBM) Understanding of pharmacy lines of business: retail, long term care, home infusion, mail order, specialty, institutional Drug information skills Analytical skills Computer proficiency with Microsoft Office (Word, Excel, PowerPoint) products Skills to handle multiple priorities and manage communications professionally to achieve issue resolution with customers, employees, or management. License or Certification required by statue or regulation: (Is a license or certificate required? What kind and type?) 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 of hire.

Required

Graduation from an accredited School of Pharmacy, B.S. or Doctor of Pharmacy degree Registered Pharmacist with a valid 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. Knowledge of the Enterprise IT Systems integration principle and associated change management best practices 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 Excellent communication skills and attention to detail with specific experience developing, editing, and presenting summaries, reports, and complex in Proven experience and working knowledge of the agile development methodologies, environment and tools Experience handling HIPPA and PII data Managed care knowledge or experience Medicaid program knowledge or related Healthcare Information experience

#J-18808-Ljbffr

  • IT Network Engineer

    3 weeks ago

    Raleigh, United States Nexstar Broadcasting Full time

    The IT Systems/Network Engineer will provide and perform all information technology support for the station, and to assist with installation and setup of other digital broadcast systems. This individual is responsible for administering the IT policies and procedures of the company, maintaining servers, printers, VPN, wireless access points, domain...

  • Network Security Engineer

    1 week ago

    Raleigh, United States HCLTech Full time

    Role : - Network Security Engineer Location: - Research Triangle Park (RTP), NC Day1 Onsite Full time hire KNOWLEDGE, SKILLS & EXPERIENCE Experience of around 10+ years with good understanding of basic networking and security concepts. Experience designing, implementing, supporting, and maintaining enterprise firewalls and services. Demonstrated ability to...

  • Network engineer

    2 weeks ago

    Raleigh, United States Cogent IBS, Inc Full time

    Required Skills: HTTP proxy configuration, integration, and administration expertise. Preferred Broadcom Bluecoat DNS configuration, scripting of API calls. Preferred BlueCat Networks Strong understanding of TCP/IP, UDP/IP, DNS, DHCP, HTTP/s and HTTP proxy. IP Mgmt, DNS, DHCP configuration, scripting of API calls. Strong understanding of TCP/IP, UDP/IP,...

  • Network wireless Engineer

    2 weeks ago

    Raleigh, United States Aliado Systems Inc Full time

    Job Title: Sr. Tier 3 Wireless Engineer IIILocation: Raleigh, NCDescription: Highly specialized in one or more phases of software systems development, systems integration, or network engineering. Provides technical assistance and advice on complex activities. Formulates / defines specifications, develops / modifies / maintains complex systems and subsystems,...

  • Networking Software Engineer

    5 days ago

    Raleigh, United States Secmation Full time

    The Network Software Developer will work with our engineering teams and be involved in developing critical cybersecurity technology to support a variety of applications including protection of network traffic, securing autonomous vehicles and critical infrastructure, and engineering tools which automate the application of security protections. In this...

  • Network Engineer

    2 weeks ago

    Raleigh, United States Motion Recruitment Full time

    A big name in retail based in Raleigh, NC is hiring for a Network Administrator II for their small, tight knit network engineering team. This position is HYBRID so only requires 3 days a week onsite in Raleigh. The role will primarily be focused on technologies including SDWAN, Azure Virtual Networks, and Cisco Meraki. The position is full time and offers...

  • Networking Software Engineer

    1 week ago

    Raleigh, United States Secmation Full time

    Job DescriptionJob DescriptionThe Network Software Developer will work with our engineering teams and be involved in developing critical cybersecurity technology to support a variety of applications including protection of network traffic, securing autonomous vehicles and critical infrastructure, and engineering tools which automate the application of...

  • Network Applications Engineer

    1 month ago

    Raleigh, United States Accentuate Staffing Full time

    Accentuate Staffing is looking for an Information Technology Professional with solid communication skills to join a growing team for one of our clients in the Raleigh, NC, area. To be considered for this position, you should be knowledgeable in computer networks and able to effectively explain the complexities of network layers and routing protocols to both...

  • Network Engineer

    2 weeks ago

    Raleigh, United States Ohm Systems, Inc Full time

    Job DescriptionThe Monitoring Systems Administrator performs complex functional activities and project management for the USPS.They will be expected to regularly exercise independent judgment, as well as high level of analytic skill, in solving complex technical problems for the USPS in the Windows and Linux based monitoring environments.This individual...

  • Network Engineer

    2 months ago

    Raleigh, United States S2S Soft Full time

    S2S Soft is looking for Network Engineer.The RoleYour responsibilities will include: This is a hands-on technical role:Provide tier-3 (expert level) operational support to resolve critical business issues that require deep network troubleshooting techniques and performance analysisIndependently own the Network Infrastructure support solving complex issues...

  • Network Engineer-VPN

    2 weeks ago

    Raleigh, United States Navitas Full time

    Job Description Job Description Network Engineer-VPN Raleigh, NC - consider alternate locations based on qualifications. Navitas Business Consulting is seeking a Network Engineer-VPN professional to provide services for our Federal Clients in Raleigh NC but we will consider alternate locations based on qualifications. Desired Skills Strong analysis...

  • Network Operations Center Engineer

    1 week ago

    Raleigh, United States Crescens Full time

    Job Title: Network Operations Center Engineer Job Location: Raleigh, NC Duration: 6+ months ( Expendable up to 2 to 3 years) Notes: ***Candidate will be working onsite for the duration of the engagement. Description: The E911 NMAC Network Operations Center (NOC) Engineers will monitor the AT&T Esinet (Emergency Services Internet Network). ...

  • Network Operations Center Engineer

    6 days ago

    Raleigh, United States Crescens Full time

    Job Title: Network Operations Center Engineer Job Location: Raleigh, NC Duration: 6+ months ( Expendable up to 2 to 3 years) Notes: ***Candidate will be working onsite for the duration of the engagement. Description: The E911 NMAC Network Operations Center (NOC) Engineers will monitor the AT&T Esinet (Emergency Services Internet Network). ...

  • Software Engineer Networking

    5 days ago

    Raleigh, United States ApTask Full time

    About the Client: The client is a division of International Industries, which designs and engineers connected products for automakers, consumers, and enterprises worldwide. These products include audio and visual products, connected car systems, and enterprise automation solutions. The division specifically focuses on the development and production of...

  • Network Engineer-VPN

    4 weeks ago

    Raleigh, United States Navitas Full time

    Job DescriptionJob DescriptionNetwork Engineer-VPN Raleigh, NC - consider alternate locations based on qualifications.Navitas Business Consulting is seeking a Network Engineer-VPN professional to provide services for our Federal Clients in Raleigh NC but we will consider alternate locations based on qualifications. Desired SkillsStrong analysis fundamentals...

  • Networking and Embedded Software Engineer

    3 weeks ago

    Raleigh, United States Secmation Full time

    Job DescriptionJob DescriptionThe software developer will work with our engineering teams and be involved in developing critical cybersecurity technology to support a variety of applications including protection of network traffic, securing autonomous vehicles and critical infrastructure, and engineering tools which automate the application of security...

  • Data Center Network Engineer

    1 month ago

    Raleigh, United States Cisco Full time

    Who We Are We are the Data Center Network Services team within Cisco IT that supports network services for Cisco Engineering and business functions worldwide. Our mission is simple - build the network of the future that is adaptable and agile on Cisco's Application Centric Infrastructure (ACI), a software-defined networking solution. ACI is deployed,...

  • Network Engineer

    3 weeks ago

    Raleigh, United States AMS Staffing Inc. Full time

    Please send your resume in WORD format should you be interested in the following Network Engineer - DNS/DHCP role with our federal client in Raleigh, NC. This position is on a temp to perm basis and will pay an hourly rate of $39/HR or $81K W2 to $77/HR or $160K W2, dependent on level of experience, with full benefits and PTO. After a brief orientation...

  • Network Engineer

    2 weeks ago

    Raleigh, United States AMS Staffing, Inc. Full time

    Job DescriptionJob DescriptionPlease send your resume in WORD format should you be interested in the following Network Engineer - DNS/DHCP role with our federal client in Raleigh, NC. This position is on a temp to perm basis and will pay an hourly rate of $39/HR or $81K W2 to $77/HR or $160K W2, dependent on level of experience, with full benefits and PTO....

  • Network Connectivity Software Engineer

    4 weeks ago

    Raleigh, United States The Maven Group, LLC Full time

    Job DescriptionJob DescriptionThe Maven Group's scientific research and engineering client in Raleigh, NC has an immediate opening for a Network Connectivity Software Engineer to join their talented and growing team. Most work will be onsite but our client is potentially open to some hybrid/remote option for ideal candidates.Our client is a 45 year...