Clinical Pharmacist - Government Programs/Medicaid Specialist

The Clinical Pharmacist – Government Programs/Medicaid Specialist works in conjunction with key internal and external stakeholders to support the clinical pharmacy-related components of our Government Programs with specific focus on Medicaid. Key areas of focus include formulary maintenance and communication, utilization management, clinical programs, drug utilization review, and quality initiatives. The individual in this role will insure that formulary-related work and drug utilization review (DUR) programs aligns with state and federal requirements. This person has a strong understanding of the unique needs of the Medicaid membership, and effectively partners with key stakeholders to tailor and coordinate clinical programs to address each Medicaid program’s needs. This individual also has strong presentation skills and a strong understanding of state specific Medicaid requirements, the health plan space, PBM business practices, and vendor management. The incumbent will need to effectively navigate a large health care organization and understand the unique needs of customers including members, providers, and internal peers. This position will interact regularly with the PBM, the medical pharmacy and MTM vendors, the Pharmacy Services team, the Medicaid product, Medica’s Care Partnership and Behavioral Health teams, and the Regulatory and Compliance teams.

Qualifications:

• Valid registered pharmacist license (in any state)
• Bachelor's degree in Pharmacy or PharmD
• 7 years of work experience

Skills and Abilities:

• Self-starter, possessing willingness and ambition to work through ambiguity
• Proven track record on consistently achieving desired results
• Previous health plan experience preferred Operates with flexibility in changing business environment
• Creative thinker Motivated to problem solve
• Customer/patient focused
• Prior experience with regulated markets from a health plan or PBM standpoint is required
• Organized individual who can simultaneously balance and- execute through multiple projects and priorities
• Collaborative, team-oriented spirit
• Excellent written and verbal communication skills
• Ability to present to an executive audience

This position is a Hub role, which requires an employee to occasionally come onsite to the designated office, Minnetonka, for applicable heads-up work. Frequency is determined by business need as decided by leadership.

Medica's commitment to diversity, equity and inclusion (DEI) includes unifying our workforce through learning and development, recruitment and retention. We consistently communicate the importance of DEI, celebrate achievements, and seek out community partnerships and diverse suppliers that are representative of everyone in our community. We are developing sustainable programs and investing time, talent and resources to ensure that we are living our values. We are an Equal Opportunity/Affirmative Action employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.

Equal Opportunity Employer/Protected Veterans/Individuals with Disabilities

The contractor will not discharge or in any other manner discriminate against employees or applicants because they have inquired about, discussed, or disclosed their own pay or the pay of another employee or applicant. However, employees who have access to the compensation information of other employees or applicants as a part of their essential job functions cannot disclose the pay of other employees or applicants to individuals who do not otherwise have access to compensation information, unless the disclosure is (a) in response to a formal complaint or charge, (b) in furtherance of an investigation, proceeding, hearing, or action, including an investigation conducted by the employer, or (c) consistent with the contractor’s legal duty to furnish information. 41 CFR 60-1.35(c)