Medicaid Executive Officer 1-Medicaid Pharmacy Support

Only applicants who meet the Minimum Qualification Requirements and meet all selective requirements (listed below) will be placed on the eligible list.

This executive officer position will coordinate with the Medicaid Pharmacist in supporting the outpatient pharmacy prescription drug benefits under the direction of the Medicaid Pharmacist. The position will require experience and understanding of Medicaid claims processing at a commercial pharmacy.

The position will require the candidate to learn and understand pharmacy policy, claims processing (including Medicaid managed care and medical claims), pharmacy benefit manager (PBM) practices, the 340B Drug Pricing Program and the Medicaid Drug Rebate Program that includes review of draft reports and documents, tracking resolution of disputes, compliance with all program requirements, participation in any audits and maintenance of state level rebate agreements.

The position will assure policy documentation including revision to existing, and development of new, pharmacy related state administrative rules, federal state plan amendments, manuals, guides, and informational letters in coordination with the Medicaid Pharmacist.

The position will coordinate and collaborate with the Medicaid Pharmacist and pharmacy contract staff and committees to ensure compliance with both Federal and State regulations to meet the goals, objectives, and priorities of the program. The responsibilities include review of draft committee documents, federal and state compliance reports related to pharmaceutical policy and assist with the committee reimbursement process.

Selectives

292 Hospital/Health Care Statistics and Reimbursement

6 months’ experience, 12 semester hours, or a combination of both in health care industry technology and standards with emphasis on health care insurance, payment systems, and health care data processing requirements.

Minimum Qualification Requirements

Applicants must meet at least one of the following minimum requirements to qualify for positions in this job classification:

• All of the following (a, b, and c): a. One year of full-time professional-level work experience in program administration, program development, program operations, or management; and b. A total of four years of education and full-time experience (as described in part a), where thirty semester hours of accredited college or university course work in any field equals one year of full-time experience; and c. A total of two years of graduate-level education and full-time experience (as described in part a), where twenty-four semester hours of accredited graduate college or university course work in a public-service-related area (e.g., public or business administration, social work, public health, law, education, engineering) equals one year of full-time experience. Graduation from the Iowa Certified Public Manager Program is also equivalent to one year of full-time experience or education.
• A total of seven years of education and/or full-time experience (as described in number one), where thirty semester hours of accredited college or university course work in any field equals one year of full-time experience.
• Current, continuous experience in the state executive branch that includes thirty months of fulltime work as a Program Planner (any level), Management Analyst (any level), or Administrative Assistant (any level).
• Graduation from an accredited four-year college or university with a degree in any field, and experience equal to three years of full-time professional-level work in program administration, program development, program operations, or management.

For additional information, please click on this link to view the job description .