Hi,
Please let me know if you can get me a perfect consultant for the below requirement!!! PBM Domain Expert Medicare Part-D, Pharmacy benefit management (PBM) Domain Expert Location: Franklin Lakes, NJ 2 Positions open. Duration : 3 months extendable 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 Thank you for your time and have a great day! Sandeep V Technical Recruiter Aim Computer Consulting <mailto:[email protected]> [email protected] [email protected] <http://www.aim-cc.com/> www.aim-cc.com cid:[email protected] Note: If your consultant's resume matches with our requirement, My BDM will contact you soon. Thanks for your efforts.
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