Pharmacy Clinical Administrator Medicaid Health Systems Administrator 4
Pharmacy Clinical Administrator Medicaid Health Systems Administrator 4
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Job Description
What You Will Do At ODM:
Office:Health Innovation & Quality
Bureau:Pharmacy/Dental
Classification:Medicaid Health Systems Administrator 4(PN
*** Preferable candidates will have experience practicing pharmacy ***
The Ohio Department of Medicaid (ODM) is recruiting for Pharmacy Clinical Administrator with significant pharmacy experience. As the Pharmacy Clinical Administrator your duties will include:
- Overseeing the development of the Preferred Drug List (PDL) approval criteria for prior authorization requests with regard to medical appropriateness dosage route of administration and duration
- Managing the development coordination and implementation of Medicaid coverage and reimbursement policies for pharmaceutical services based upon broad federal guidelines state regulations Medicaid Drug Rebate Program litigation administrative decisions and analysis of legislation
- Implementing proposed policies through rule promulgation process
- Ensuring compliance with state and federal laws and guidance regarding Single Pharmacy Benefit Manager (SPBM) Pharmacy Pricing and Audit Consultant (PPAC) pharmacy claims processing and payment
- Representing the Director on behalf of the agency
- Supervising assigned staff
- Making recommendations for hire
- Assigning work and providing direction
- Reviewing work and providing feedback
- Establishing goals monitoring and evaluating performance
Ohio is a Disability Inclusion State and strives to be a model employer of individuals with disabilities. The State of Ohio is committed to providing access and inclusion and reasonable accommodation in its services activities programs and employment opportunities in accordance with the Americans with Disabilities Act (ADA) and other applicable laws.
At the State of Ohio we take care of the team that cares for Ohioans. We provide a variety of quality competitive benefits to eligible fulltime and parttime employees*. For a list of all the State of Ohio Benefits visit ourTotal Rewards website! Our benefits package includes:
- Medical Coverage
- Free Dental Vision and Basic Life Insurance premiums after completion of eligibility period
- Paid time off including vacation personal sick leave and 11 paid holidays per year
- Childbirth Adoption and Foster Care leave
- Education and Development Opportunities (Employee Development Funds Public Service Loan Forgiveness and more)
- Public Retirement Systems such as OPERS STRS SERS and HPRS&Optional Deferred Compensation Ohio Deferred Compensation
*Benefits eligibility is dependent on a number of factors. The Agency Contact listed above will be able to provide specific benefits information for this position.
Completion of graduate core program in business management or public administration public health health administration social or behavioral science or public finance; 48 mos. exp. in planning & administering health services program or health services project management (e.g. health care data analysis health services contract management health care market & financial expertise; health services program communication; health services budget development HMO & hospital rate development health services eligibility health services data base analysis).
Or 12 months experience as a Medicaid Health Systems Administrator 3 65297. Note: education & experience is to be commensurate with approved position description on file.
Or equivalent of Minimum Class Qualifications for Employment noted above.
Job Skills: Pharmacist Health Administration
Professional Skills:Collaboration Goal Setting Innovation Leading Others Managing Meetings Organizing and Planning Performance Management Priority Setting Decision Making Delegation Strategic Thinking
The State of Ohio is a drugfree workplace which prohibits the use of (recreational /nonmedical cannabis). Please note this position may be subject to additional restrictions pursuant to the State of Ohio DrugFree Workplace Policy (HR39 and as outlined in the posting.
Supplemental Information:
THIS POSITION IS OVERTIME EXEMPT.
This position is unclassified per 124.11 (A) 9 Ohio Revised Code. Travel required as needed. Must provide own transportation. Or in order to operate a state vehicle you must have a valid drivers license from state of residence.
THE WORK LOCATION OF THIS POSITION IS 50 WEST TOWN STREET COLUMBUS OHIO 43215. YOU WILL BE REQUIRED TO REPORT TO THIS WORK LOCATION IF SELECTED.
Resumes and/or attachments are not reviewed. Therefore please provide detail in the work experience section of your application.
About Us:
Investing in opportunities for Ohioans that work for every person and every family in every corner of our state is at the hallmark of Governor DeWines agenda for Ohios future. To ensure Ohio is the best place to live work raise and family and start a business we must have strong schools a great quality of life and compassion for those who need our help.
Ohio Department of Medicaid plays a unique and necessary role in supporting the governors vision. As the single state Medicaid agency responsible for administering highquality personcentric healthcare the department is committed to supporting the health and wellbeing of nearly one in every four Ohioans served. We do so by:
- Delivering a personalized care experience to more than three million people served.
- Improving care for children and adults with complex behavioral health needs.
- Working collectively with our partners and providers to measurably strengthen wellness and health outcomes.
- Streamlining administrative burdens so doctors and healthcare providers have more time for patient care.
- Ensuring financial transparency and operational accountability across all Medicaid programs and services.
Required Experience:
Unclear Seniority
Employment Type
Full-Time
