PBM Business Change Manager
Core
Identify and implement projects and plans to support business unit and enterprise goals, including process redesign and system integration.
Role type
Senior IC business change manager (PBM/Pharmacy)
Builds
Process and system improvements for pharmacy benefits and claims adjudication
Domain
Health insurance / Pharmacy Benefit Management (PBM)
Deliverable
production ML models | product features | dashboards & analysis | client delivery | infrastructure
Required skills
PBM/Pharmacy domain expertise, end-to-end UAT leadership, pharmacy claim submission and validation, cost/benefit analysis, process redesign, JIRA/Smartsheet proficiency, GenAI tool usage
Preferred skills
Leading onshore/offshore testing resources, managing significant operating budgets, root-cause analysis, defect triage, cross-functional stakeholder management
Technologies
JIRA, Smartsheet, ChatGPT, Microsoft Copilot
Responsibilities
Identify project scope and charge, lead best practice identification, design processes and systems, conduct cost/benefit analyses, build support for business change
Seniority
Senior, hands-on IC