Hello Friends,
Please find the requirement and send me the resume with the contact details asap at [email protected] PBM Domain Expert Medicare Part-D, Pharmacy benefit management (PBM) Domain Expert Location: Franklin Lakes, NJ 2 Positions open. Duration : 3 months extendable Employee would work from: Franklin Lakes, NJ Rate- $40/hr CTC Through understanding and up to date knowledge of CMS 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 10+ years of experience in testing in Medicare Part-D setup Job Duties: Test process consulting for Medicare Part-D setup, identify the gaps in existing business process and potential compliance issues. Skills Required: Medicare Part-D domain expertise, Testing expertise in Medicare Part-D setup, Business process and test process consulting Minimum Education: Graduate Minimum Experience: 10 Years Additional Posting Information: Through understanding and up to date knowledge of CMS 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. 10+ years of experience in testing in Medicare Part-D setup and very well versed with * 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 Thanks & regards, Liju George Thomas Phone: 734-591-3562X1171 Fax : 734-418-2603 <mailto:[email protected]> [email protected] I [email protected] <http://www.aim-cc.com/> www.aim-cc.com clip_image001 AS YOU GROW HELP OTHERS GROW Note: We respect your Online Privacy. This is not an unsolicited mail. Under Bills 1618 Title III passed by the 105th U.S. Congress, this mail cannot be considered Spam as long as we include contact information and a method to be removed from our mailing list. To be removed from our mailing list, please reply with "REMOVE" in the subject line and your email address in the body. Include Complete Address and/or Domain/Aliases to be removed. We sincerely regret any inconvenience. "Arise, shine." Isaiah 60:1a. cid:[email protected]
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