MES PBM Product Integration Specialist

Seeking a Pharmacy Benefits Management (PBM) Product Integration Specialist to join the Medicaid Enterprise System (MES) project.

Details

The PBM Product Integration Specialist will serve as a member of the Medicaid Enterprise System (MES) Program within the Product Management space. This position will support the product manager to champion our department’s key strategies with the goal of creating the opportunity for healthier outcomes for our citizens through clinical and technological innovation. This position is responsible for supporting independent product oversight for Medicaid, specifically the Pharmacy Benefits Management (PBM). Expert knowledge of Medicaid Pharmacy Benefits Management processes, intended outcomes, and pain points is essential. This oversight may include development and monitoring of the Medicaid Managed Care product strategies, while collaborating with other divisions and external stakeholders to develop and implement targeted strategies to streamline processes.
•    Supports cross-functional activities that provide effective oversight of Medicaid Programs.
•    Works closely with the Product Manager in achieving direct and hybrid reporting relationships and staff, sets priorities, establishes accountabilities, and defines roles/responsibilities to secure necessary resources not under direct supervision, while maintaining peak levels of performance and compliance.
•    Collaborates and communicates with workgroups around product deliverables with Product Managers, Product Owners, Business Leads.
•    In-depth knowledge and understanding of products across functions and business segments in healthcare that meet departmental goals.
•    Ability to research and recommend the development and implementation of new product initiatives, including current product enhancements.
•    Provides feedback and input to senior level decision-makers to develop long-range strategic alternatives for product solutions.
•    Must have experience with Medicaid/Health Care and/or Managed Care areas.
•    Good understanding of CMS MITA Framework across Medicaid Business Architecture, Information Architecture and Technical Architecture initiatives and activities.
•    Prior experience with Medicaid applications and preferably across Pharmacy Functional Areas.
•    Through a variety of communication/meeting methods, confirm the business owner needs and help translate them into detailed and actionable requirements as needed.
•    Provide in-person, conference calls, or virtual training on product knowledge, usage, and implementation.
•    Able to document database queries to analyze performance indicators, evaluate survey data, define successful criteria for testing and product acceptance.
•    Ensures compliance with all applicable policies and procedures.
•    Supporting the product lifecycle from conception through implementations.
•    Able to assess emerging products and partners to measure and address their potential value or risk to the department, as well as make recommendations on which modern technologies to invest in or leverage.
•    Adhere to the Product Management guidelines.
•    Research and gather the information needed for the Product to evaluate and analyze the work done by Medicaid SMEs, Business and Technical Leads, Data Leads, Engineers, and Architects to ensure the business requested capability, implemented design, and delivered functionality is successful and useful to the stakeholders.
•    Familiarity with CMS Certification process
•    Performs other duties as assigned.

In addition, the Product Integration Specialist is responsible for supporting the Product Management space to achieve successful development of IT systems in support of the Medicaid program. The Product Integration Specialist will actively work with the Product Manager in expressly engage with the business owners to develop the strategy behind how each MES module will support the business requirements definition and will own the translation and specification of all functional requirements. This position will work integrally with MES Product Managers and the Business core to support maintaining and managing all the vendor deliverables, artifacts, help to manage the launch of features and systems.

Requirements:

-Expert knowledge of the Medicaid Pharmacy (PBM) processes, roles, and intended outcomes
-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 Project, Word, Excel, PowerPoint, Access, and Adobe software
-Skills in persuasion, negotiation, relationship management, conflict resolution, and effective oral and written communication at all levels
-Previous experience creating business use cases, requirements, and process maps/data flows
-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
-Expert knowledge of the Medicaid Pharmacy (PBM) processes, roles, and intended outcomes
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 Project, Word, Excel, PowerPoint, Access, and Adobe software
Skills in persuasion, negotiation, relationship management, conflict resolution, and effective oral and written communication at all levels
Previous experience creating business use cases, requirements, and process maps/data flows
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
-Expert knowledge of the Medicaid Pharmacy (PBM) processes, roles, and intended outcomes
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 Project, Word, Excel, PowerPoint, Access, and Adobe software
Skills in persuasion, negotiation, relationship management, conflict resolution, and effective oral and written communication at all levels
Previous experience creating business use cases, requirements, and process maps/data floes
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
-Experience handling HIPPA and PII data
-Managed care knowledge or experience
-MITA knowledge and understanding of the CMS’s Seven Standards and conditions
-Medicaid program knowledge or related Healthcare Information experience

Other Desired Requirements:
-Proven experience and working knowledge of the agile development methodologies, environment, and tools
-Experience using or implementing Cloud technologies Iaas, Paas, Saas
-Ability to gather data via diverse means (i.e., interviews, observation, surveys, existing written documentation) and interpret relevant information