<p>Roles & Responsibilities</p> <p>Contribute to business requirements for new and existing systems from ideation through production and project oversight.</p> <p>Extraction of requirements from business sources</p> <p>Discussions with technical resources on business intent and requirements</p> <p>Skills to discuss, if not influence, technical design of associated applications</p> <p>Participate in defining business requirements with business sponsors, TPO and System Engineering teams for new and modified business applications, product, or client requests</p> <p>Apply new technical tools and techniques to support business</p> <p>Provide input and insight into technical design of new and existing business applications.</p> <p>Owns the creation of epics to support analytic needs</p> <p>Participates in essential meetings, ceremonies, and release planning conversations to ensure training or documentation resources support a successful adoption</p> <p>Communicate and report on progress regularly with stakeholders</p> <p>Prioritize and manage workload and meet project deadlines.</p> <ul> <li>Serve as a business SME for PBM (Pharmacy Benefit Manager) related processes, including: </li></ul> <p>o Clinical policies and prior authorizations</p> <p>o Drug Utilization Review (DUR) & lock-in programs</p> <p>o Preferred Drug List (PDL) & Medicaid Drug Rebate Program (MDRP)</p> <p>o Collaborate with PBM stakeholders, vendor</p> <p>o PBA Setup</p> <p>o PBM Regulatory</p> <p>o Patient Assistance</p> <p>o Clinical Transformation</p> <ul> <li>Experience in working and setting up PBA would be highly desirable </li><li>Should be aware of the industry's direction and where it is heading </li><li>Familiarity with the best practices in the PBM field is required </li><li>Should be able to envision the future PBM setup for the Patient Assistance Programs, Self-funded Commercial, Coupon Programs, Incentive Model, Formulary / Clinical Transformation, PBM Regulatory, and Compliance programs </li><li>Should have knowledge of the dos and don'ts associated with the above-mentioned programs </li></ul> <p>Proven experience as a Product Owner, Product Manager, or Business Analyst in PBM(Pharmacy Benefit Manager) domain.</p> <p>Knowledge of PBM workflows such as:</p> <ul> <li>Pharmacy claims processing & adjudication </li><li>Formulary & benefit design </li><li>Prior authorization and utilization management </li><li>Specialty pharmacy operations </li></ul> <p>< div>• Strong understanding of healthcare standards: HIPAA, NCPDP</p> <ul> <li>Ability to gather requirements, write user stories, and manage product backlogs in Agile/Scrum environments. </li><li>Excellent communication and stakeholder management skills. </li><li>Proficiency with tools such as JIRA, Confluence, Azure DevOps </li></ul> <p>Salary Range: $140,000 $170,000 Year</p> <p>TCS Employee Benefits Summary:</p> <p>Discretionary Annual Incentive.</p> <p>Comprehensive Medical Coverage: Medical & Health, Dental & Vision, Disability Planning & Insurance, Pet Insurance Plans.</p> <p>Family Support: Maternal & Parental Leaves.</p> <p>Insurance Options: Auto & Home Insurance, Identity Theft Protection.</p> <p>Convenience & Professional Growth: Commuter Benefits & Certification & amp; Training Reimbursement.</p> <p>Time Off: Vacation, Time Off, Sick Leave & Holidays.</p> <p>Legal & Financial Assistance: Legal Assistance, 401K Plan, Performance Bonus, College Fund, Student Loan Refinancing.</p> <p>#LI-SP1</p>