Pharmacy Benefit Administration Specialist - Remote

Overview

The Pharmacy Benefit Administration Specialist is responsible for supporting various aspects of the design, development, implementation, and maintenance of a new PBM module as part of the Medicaid Enterprise System Modernization Program.

In Short

• Remote work with some travel (10%).
• Support design and implementation of the PBM module.
• Ensure business requirements are met and processes are established.
• Collaborate with team members, stakeholders, and vendors.
• Provide expertise in Pharmacy Benefit Administration.
• Review PBA deliverables for compliance with requirements.
• Support cross-module planning and data integration.
• Assist in testing efforts to ensure compliance.
• Identify issues and provide management recommendations.
• Support CMS certification processes.

Requirements

• Bachelor’s degree in Business, Public Administration, or related field.
• Strong understanding of Medicaid programs and CMS oversight.
• Minimum of six years of experience in PBA or PBM.
• Experience engaging large stakeholder groups.
• Excellent organization, analytic, and communication skills.
• Preferred: Experience with State Medicaid modernization initiatives.
• Preferred: Familiarity with CMS MITA framework and APD/CPR processes.
• Preferred: Familiarity with Gainwell’s MMIS system.

Benefits

• Opportunity to work remotely.
• Engagement with diverse stakeholders.
• Involvement in significant Medicaid initiatives.
• Professional development opportunities.
• Competitive compensation.