Tata Consultancy Services · 2 days ago
Pharmacy Benefit Management SME/Product Owner
Morris Plains, NJ
Full-time
Onsite
Mid, Senior Level
$140K/yr - $170K/yrTata Consultancy Services is a global leader in IT services, consulting, and business solutions. They are seeking a Pharmacy Benefit Management SME/Product Owner to contribute to business requirements and oversee project management from ideation through production, ensuring the successful adoption of business applications.
Business Information SystemsConsultingInformation TechnologyIT Management
Responsibilities
Contribute to business requirements for new and existing systems from ideation through production and project oversight
Extraction of requirements from business sources
Discussions with technical resources on business intent and requirements
Skills to discuss, if not influence, technical design of associated applications
Participate in defining business requirements with business sponsors, TPO and System Engineering teams for new and modified business applications, product, or client requests
Apply new technical tools and techniques to support business
Provide input and insight into technical design of new and existing business applications
Owns the creation of epics to support analytic needs
Participates in essential meetings, ceremonies, and release planning conversations to ensure training or documentation resources support a successful adoption
Communicate and report on progress regularly with stakeholders
Prioritize and manage workload and meet project deadlines
Serve as a business SME for PBM (Pharmacy Benefit Manager) related processes, including:
Clinical policies and prior authorizations
Drug Utilization Review (DUR) & lock-in programs
Preferred Drug List (PDL) & Medicaid Drug Rebate Program (MDRP)
Collaborate with PBM stakeholders, vendor
PBA Setup
PBM Regulatory
Patient Assistance
Clinical Transformation
Experience in working and setting up PBA would be highly desirable
Should be aware of the industry's direction and where it is heading
Familiarity with the best practices in the PBM field is required
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
Should have knowledge of the dos and don'ts associated with the above-mentioned programs
Proven experience as a Product Owner, Product Manager, or Business Analyst in PBM(Pharmacy Benefit Manager) domain
Knowledge Of PBM Workflows Such As
Pharmacy claims processing & adjudication
Formulary & benefit design
Prior authorization and utilization management
Specialty pharmacy operations
Strong understanding of healthcare standards: HIPAA, NCPDP
Ability to gather requirements, write user stories, and manage product backlogs in Agile/Scrum environments
Excellent communication and stakeholder management skills
Proficiency with tools such as JIRA, Confluence, Azure DevOps
Qualification
Required
Bachelor of Computer Science
Proven experience as a Product Owner, Product Manager, or Business Analyst in PBM (Pharmacy Benefit Manager) domain
Familiarity with the best practices in the PBM field is required
Strong understanding of healthcare standards: HIPAA, NCPDP
Ability to gather requirements, write user stories, and manage product backlogs in Agile/Scrum environments
Excellent communication and stakeholder management skills
Proficiency with tools such as JIRA, Confluence, Azure DevOps
Preferred
Experience in working and setting up PBA would be highly desirable
Should be aware of the industry's direction and where it is heading
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
Should have knowledge of the dos and don'ts associated with the above-mentioned programs
Benefits
Discretionary Annual Incentive.
Comprehensive Medical Coverage: Medical & Health, Dental & Vision, Disability Planning & Insurance, Pet Insurance Plans.
Family Support: Maternal & Parental Leaves.
Insurance Options: Auto & Home Insurance, Identity Theft Protection.
Convenience & Professional Growth: Commuter Benefits & Certification & Training Reimbursement.
Time Off: Vacation, Time Off, Sick Leave & Holidays.
Legal & Financial Assistance: Legal Assistance, 401K Plan, Performance Bonus, College Fund, Student Loan Refinancing.
Company
Tata Consultancy Services
Tata Consultancy Services is a business solutions company that specializes on information technology services and consulting.
Founded in 1968
10001+ employees
H1B Sponsorship
Tata Consultancy Services has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (7880)
2024 (9690)
2023 (8537)
2022 (11159)
2021 (9813)
2020 (11984)
Funding
Current Stage
Public CompanyTotal Funding
unknown2004-08-25IPO
Leadership Team
K. Krithivasan
Chief Executive Officer & Managing Director
Aarthi Subramanian
President and Chief Operating Officer
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