Head of Programme Management

Roles & 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: o Clinical policies and prior authorizations o Drug Utilization Review (DUR) & lock-in programs o Preferred Drug List (PDL) & Medicaid Drug Rebate Program (MDRP) o Collaborate with PBM stakeholders, vendor o PBA Setup o PBM Regulatory o Patient Assistance o 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

Generic Managerial Skills, If any

• Very good communication skills
• Good Analytical skills
• Ability to operate within a fast-paced work environment a plus
• Excellent communication (oral and written), facilitation, presentation, and organization skills

required

• Excellent organization skills preferred
• Proven ability to manage multiple projects simultaneously required
• Demonstrated problem solving and organization capabilities preferred

Key Words to search in Resume

• Product Owner / Product Manager
• PBM (Pharmacy Benefit Manager) related processe