Brand New Opening - Immediate Need for two Business Analysts in NJ!

Phase 3 seeks Pharmacy Benefit Management Domain Experts (Business Analysts) for direct hire jobs in New Jersey.  We have TWO (2) IMMEDIATE job  opportunities that must be filled in February 2011.  Come work for the world’s largest quality assurance testing company onsite at a global pharmaceutical corporation, where you will analyze and validate the business user requirements, translate the business user requirements into use cases, help teams in converting use cases into test scenarios for various testing events, and validate the test cases developed by teams against requirements.

Required Skills and Qualifications:

BS/BA Degree

7-10 years of experience testing in Medicare Part-D setup

Thorough understanding and up to date knowledge of CMS (Centers for Medicare & Medicaid Services) policies and guidelines around Medicare Part-D and PBM

Ability to review/audit the existing business process and identify  the gaps

Sound knowledge of Prescription Drug Plan design procedure and administering Pharmacy benefit management for health plan clients

Knowledge of Part A, Part B and Part C plans

Excellent communication and presentation skills

Thorough understanding of Pharmacy Benefit Management components including:

• Eligibility and Enrollment
• Coverage determination
• Appeals and Grievances
• Coordination of benefits
• Fraud and abuse
• State pharmaceutical assistance program
• Rights and protection
• Billing
• Transition process
• Claim processing (Rx claims) and adjudication
• Benefits
• Marketing guidelines/Rebates
• Drug classification and formularies
• Accumulators
• Prior Auth and Exceptions
• Multi Payer – Other health insurance
• Privacy
• CMS Pricing files
• PDE – Prescription Drug Event
• MTM – Medication therapy management
• Formulary Pricing

Details:

Job Title: Pharmacy Benefit Management Domain Experts

Job Type: Direct Hire

Vendor: Phase 3 Recruiting LLC

Client Site: MEDCO in Franklin Lakes, NJ

Number of Positions: Two (2)

Salary range: $70-90K DOE

Start Date: IMMEDIATE

The Next Phase

If you are interested in moving to the next phase of your career, and you are qualified for this opportunity, please click on the link below to apply, or email your resume to: recruiter@phase3recruiting.com.

 Move to the Next Phase: Phase 3