BA Pharmacy (PBM)

Summary

About Gainwell:
Gainwell Technologies is the leading provider of technology solutions that are vital to the administration and operations of health and human services programs. We are the key player in the Medicaid space with a presence in 51 of the 56 U.S. states and territories with offerings including Medicaid Management Information Systems (MMIS), Fiscal Agent Services, Program Integrity, Care Management, Immunization Registry, and Eligibility Services. We generate over $2 billion in annual revenue, and we’ve been innovating in the industry for more than 50 years. Powered by more than 14,000 employees, Gainwell solutions support more than 60 million Medicaid beneficiaries nationwide and manage 1 billion encounters annually. Additionally, about 1.5 billion immunization records aremaintained, and we serve more than 3 million providers annually.
 
We do this while saving our state and commercial clients ~5.5 billion dollars annually in cost avoidance. Our commitment to clients drives continuous improvement in the quality of healthcare for beneficiaries nationwide
through vital healthcare technology.
 
In summary, there’s no company better positioned in the Medicaid and HHS (Health and Human Services) market than Gainwell.
 
For more information on Gainwell, visit www.gainwelltechnologies.com

Your role in our mission

Essential Job Functions

• Assists in planning and designing business processes; assists in formulating recommendations to improve and support business activities.
• Assists in analyzing and documenting client's business requirements and processes; communicates these requirements to technical personnel by constructing basic conceptual data and process models, including data dictionaries and volume estimates.
• Assists in creating basic test scenarios to be used in testing the business applications in order to verify that client requirements are incorporated into the system design.
• Assists in developing and modifying systems requirements documentation to meet client needs.
• Participates in meetings with clients to gather and document requirements and explore potential solutions.
• Executes systems tests from existing test plans. Assists in analyzing test results in various phases.
• Participates in technical reviews and inspections to verify 'intent of change' is carried through phase of project.

Basic Qualifications

• Bachelor's degree or equivalent combination of education and experience
• Bachelor's degree in business administration, information systems, or related field preferred
• Three or more years of business analysis experience
• Experience working with the interface of information technology with functional groups within an organization
• Experience working with business processes and re-engineering
• Experience working with computer programming concepts and basic language

Other Qualifications

• Interpersonal skills to interact with customers and team members
• Communication skills
• Analytical and problem solving skills
• Presentation skills to communicate with management and customers
• Personal computer and business solutions software skills
• Ability to work in a team environment with multiple team members and the ability to multitask
• Willingness to travel

Work Environment

• Office environment

What we're looking for

Education and Experience:

Required: Doctor of Pharmacy (PharmD) or Bachelor’s Degree in Pharmacy (B.Pharm).
Experience: 4+ years total, with 2+ years in clinical pharmacy, preferably in Medicaid/Medicare.

Skills and Competencies:

Regulatory Knowledge: Expertise in US Medicaid regulations, claim adjudication workflows, prior authorizations, DUR, and drug rebate programs.
Technology Proficiency: Familiarity with pharmacy management systems, electronic health records (EHR) & different drug data sources specific to US.
Clinical Expertise: Strong knowledge of drug therapy management and patient counseling.
Communication: Exceptional verbal and written communication skills.

What you should expect in this role

Fast-paced,challenging and rewarding work environment.
Work life balance.    
Hybrid Office environment.
Will require late evening work to overlap US work hours.