Job ID: NC-652456 (93690602)
Pharmacy Analyst with claims, FDB, NDC, GSN, GCN, Medicaid PDL, ProDUR, RetroDUR experience
Location: Raleigh, NC (NCDHHS)
Duration: 12 months
Interview: Either Webcam Interview or In Person
Positions:1(1/1)
Skills :’
Experience with Pharmacy claim adjudication Required
Working knowledge of First Data Bank (FDB) drug classifications such as therapeutic drug classes, NDCs, GSNs, GCNs, etc.), drug dosage, packaging/pric Required
Understanding of Medicaid PDL (for generic and brand drugs), preferred/non-preferred drug Required
Understanding of Medicaid prior authorization criteria/rules, lock-in program requirements and drug utilization review (both ProDUR and RetroDUR). Required
Experience with gathering requirements and interpreting business rules Required
Strong organizational, time management, communication, and detail-oriented skills Required
Excellent communication, negotiation, conflict resolution and persuasion abilities Required
Position Overview:
This position will serve as a member of the Business Technology Relationship Management team. The unit is responsible for managing relationship between the DHB program/functional areas and the Technology that supports the business and supports all of the division.
Job Specific Responsibilities
Monitor PHP data reports and identify issues
Research Pharmacy issues
Identify defects and track to resolution
Request system enhancements and track to resolution
Preferred Knowledge, Skills, and Abilities:
-Experience with Pharmacy claim adjudication
-Working knowledge of First Data Bank (FDB) drug classifications such as therapeutic drug classes, NDCs, GSNs, GCNs, etc.), drug dosage, packaging and pricing
-Understanding of Medicaid PDL (for generic and brand drugs), preferred/non-preferred drug, prior authorization criteria/rules, lock-in program requirements and drug utilization review (both ProDUR and RetroDUR).
-Experience with gathering requirements and interpreting business rules
-Demonstrated ability to work independently in a fast-paced environment with concurrent deadlines
-Excellent communication, negotiation, conflict resolution and persuasion abilities
-Strong organizational, time management, communication, and detail-oriented skills
-Highly proficient with Microsoft Outlook, Word and Excel