Job Description

The PBM Product Integration Specialist will serve as a member of the DHHS Medicaid Enterprise System (MES) Program within the Product Management space.

The PBM Product Integration Specialist will serve as a member of the DHHS Medicaid Enterprise System (MES) Program within the Product Management space. This position will support the product manager to champion our department s key strategies with the goal of creating the opportunity for healthier outcomes for our citizens through clinical and technological innovation. This position is responsible for supporting independent product oversight for NCDHHS Medicaid, specifically the Pharmacy Benefits Management (PBM). Expert knowledge of Medicaid Pharmacy Benefits Management processes, intended outcomes, and pain points is essential. This oversight may include development and monitoring of the Medicaid Managed Care product strategies, while collaborating with other DHHS divisions and external stakeholders to develop and implement targeted strategies to streamline processes. This position will actively work with the Pharmacy Business to develop the business process documents, create user stories, business case scenarios, identify user acceptance test case scenarios, research, and document in relation to Medicaid initiatives and strategic goals. The Product Integration Specialist goes hand in hand for the Product Manager and Core Business team and represents DHHS business functions within NC Medicaid and functions within the Product Management Space. This position sometimes may require interacting with the NC Medicaid Business Information Analytics Office, DHHS Data Office, Information Technology Division, Privacy and Security Office, Policy Office, General Counsel, Office of Procurement, Contracts and Grants, among others.
Supports cross-functional activities that provide effective oversight of Medicaid Programs.
Works closely with the Product Manager in achieving direct and hybrid reporting relationships and staff, sets priorities, establishes accountabilities, and defines roles/responsibilities to secure necessary resources not under direct supervision, while maintaining peak levels of performance and compliance.
Collaborates and communicates with workgroups around product deliverables with Product Managers, Product Owners, Business Leads.
In-depth knowledge and understanding of products across functions and business segments in healthcare that meet departmental goals.
Ability to research and recommend the development and implementation of new product initiatives, including current product enhancements.
Provides feedback and input to senior level decision-makers to develop long-range strategic alternatives for product solutions.
Must have experience with Medicaid/Health Care and/or Managed Care areas.
Good understanding of CMS MITA Framework across Medicaid Business Architecture, Information Architecture and Technical Architecture initiatives and activities.
Prior experience with Medicaid applications and preferably across Pharmacy Functional Areas.
Through a variety of communication/meeting methods, confirm the business owner needs and help translate them into detailed and actionable requirements as needed.
Provide in-person, conference calls, or virtual training on product knowledge, usage, and implementation.
Able to document database queries to analyze performance indicators, evaluate survey data, define successful criteria for testing and product acceptance.
Ensures compliance with all applicable policies and procedures.
Supporting the product lifecycle from conception through implementation.
Able to assess emerging products and partners to measure and address their potential value or risk to the department, as well as make recommendations on which modern technologies to invest in or leverage.
Adhere to the Product Management guidelines.
Research and gather the information needed for the Product to evaluate and analyze the work done by Medicaid SMEs, Business and Technical Leads, Data Leads, Engineers, and Architects to ensure the business requested capability, implemented design, and delivered functionality is successful and useful to the stakeholders.
Familiarity with CMS Certification process
Performs other duties as assigned.
In addition, the Product Integration Specialist is responsible for supporting the Product Management space to achieve successful development of IT systems in support of the Medicaid program. The Product Integration Specialist will actively work with the Product Manager in expressly engage with the business owners to develop the strategy behind how each MES module will support the business requirements definition and will own the translation and specification of all functional requirements. This position will work integrally with MES Product Managers and the Business core to support maintaining and managing all the vendor deliverables, artifacts, help to manage the launch of features and systems.

Required/Desired Skills

Skill Required /Desired Amount of Experience
Expert knowledge of the Medicaid Pharmacy (PBM) processes, roles, and intended outcomes	Required	3	Years
Knowledge of the Enterprise IT Systems integration principle and associated change management best practices	Required	7	Years
Demonstrate ability to manage multiple priorities and projects, and function in a fast passed moving constantly changing, deadline-driven environment	Required	7	Years
Proficient in Microsoft Project, Word, Excel, PowerPoint, Access, and Adobe software	Required	7	Years
Skills in persuasion, negotiation, relationship management, conflict resolution, and effective oral and written communication at all levels	Required	7	Years
Previous experience creating business use cases, requirements, and process maps/data floes	Required	7	Years
Experience working in a combination of business analysis. Product management, project management, and or software application development	Required	7	Years
Excellent communication skills and attention to detail with specific experience developing, editing, and presenting summaries, reports, and complex in	Required	7	Years
Proven experience and working knowledge of the agile development methodologies, environment, and tools	Highly desired	7	Years
Experience using or implementing Cloud technologies Iaas, Paas, Saas	Highly desired	5	Years
Experience handling HIPPA and PII data	Required	5	Years
Ability to gather data via diverse means (i.e., interviews, observation, surveys, existing written documentation) and interpret relevant information	Highly desired	5	Years
Managed care knowledge or experience	Required	3	Years
MITA knowledge and understanding of the CMS s Seven Standards and conditions	Required	7	Years
Medicaid program knowledge or related Healthcare Information experience	Required	5	Years

Questions

No. Question
Question1	Absences greater than two weeks MUST be approved by CAI management in advance, and contact information must be provided to CAI so that the resource can be reached during his or her absence. The Client has the right to dismiss the resource if he or she does not return to work by the agreed upon date. Do you accept this requirement?
Question2	This posting is preferred as Hybrid but remote is available as long as previously discussed,
Question3	Candidate must be able to attend webcam interview. Do you accept this requirement?
Question4	Please list candidate s email address.
Question5	Please indicate how soon this candidate is available to start work. Vendors are encouraged to submit candidates that are available for the duration of the assignment.
Question6	Vendor must disclose to the agency if the candidate will be subcontracted at the time of submission. Do you accept this requirement?
Question7	Vendor must notify the agency if any portion of the requirements listed in this task order is to be outsourced to other countries. Do you accept this requirement?
Question8	Candidates submitted above the rate of XX85.55 will not be considered. Do you accept this requirement?
Question9	Payment for all approved hours will be paid at the straight hourly rate regardless of the total hours worked by the engaged resource. It is the responsibility of the supplier to adhere to any applicable compensation laws including payment for overtime hours. Do you accept this requirement?
Question10	Please confirm you have thoroughly validated, and attest to the accuracy of, the credentials listed throughout this candidate s VectorVMS profile and resume pursuant to Section 5.2.5 of ITS-009440. Do you confirm?

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