Job Description:
Serve as a subject matter expert for the Pharmacy Business Unit within the Medicaid Enterprise System (MES) Program. Provide expertise and business support in the development and implementation of the Medicaid Enterprise Modular PBM Solution. Assist with onboarding the PBM vendor, serving as a business stakeholder and representing the Pharmacy Business Unit throughout implementation. Lead and provide guidance on Clinical policies and Prior Authorizations, Drug Utilization Review (DUR) and pharmacy lock-in processes, Behavioral Health and A+ Kids programs, Preferred Drug List (PDL) and Medicaid Drug Rebate Program (MDRP), and Physician Administered Drug Program (PADP). Collaborate with the Pharmacy Business team to define business process documents, business use cases, business case scenarios, and user acceptance test case scenarios. Actively support cross-functional activities to provide oversigh...