Business Analyst With Pharmacy Benefit Management - Remote

The Dignify Solutions, LLC

  • Edison, NJ
  • 19 days ago
  • Remote

    Highlights

    Candidate should have deep understanding of First Data Bank (FDB) Drug nomenclature and how to use FDB nomenclature in designing / configuring drug coverage (inclusions/exclusions/PA Criteria) or building Formulary / Preferred Drug Lists. Willing to consider less experienced candidates who can demonstrate depth in understanding PBM area.

    Numbers & Facts

    LocationEdison, NJ (
    Remote
    )

    Description

    • Minimum Qualifications:
    • Ideally 10+ years experience working in PBM domain (Claims processing related).
    • Willing to consider less experienced candidates who can demonstrate depth in understanding PBM area.
    • Candidate should have deep understanding of First Data Bank (FDB) Drug nomenclature and how to use FDB nomenclature in designing / configuring drug coverage (inclusions/exclusions/PA Criteria) or building Formulary / Preferred Drug Lists.
    •  Candidate should have a good understanding of PBM Claims processing and related NCPDP standards (D.0 at least) and common business rules around Drug Utilization (ProDUR related).
    •  College degree is preferred. Industry experience can be considered as substitute.
    •  Candidates who have strong Clinical background e.g. Pharmacists but no BA background are welcome to apply (provided they are willing to perform BA role with inhouse training)

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