Clinical Pharmacist

Location: 4345 N Lincoln Blvd Oklahoma City OK 73105

Salary: $112705/year

Work Schedule: Monday Friday

Primary Hours: 8:00 a.m. 5:00 p.m.

The Oklahoma Health Care Authority (OHCA) works to ensure Oklahomans have access to better health and better care. The agencys core values include passion for purpose trust and transparency empowerment and accountability best in class and outcome-driven and servant leadership. As part of the interview process candidates may be required to attend an in-person interview at our Oklahoma City office.

The Pharmacist provides advanced clinical and technical support to the agencys pharmacy programs. This role focuses heavily on pharmacy data analytics system logic evaluation and the optimization of healthcare technology platforms including MMIS. The incumbent will analyze complex claims data evaluate system edits and collaborate on technical workflows to ensure program efficiency and compliance.

• Analyzes pharmacy program and recommends interventions for cost-effective use of resources.

• Analyzes claims utilization for clinical issues using MMIS Business Objects and Excel.

• Designs and drafts member and provider intervention and education projects working with Pharmacy Management Consultants at the OU College of Pharmacy.

• Supports and assists Pharmacy Director with policy development through reporting and analysis budget planning rule drafting and State Plan amendments.

• Supports and assists Pharmacy Director with MMIS claims processing enhancements such as new edits or audits.

• Directs and monitors pharmacy program contractor activities and assists in contract language negotiation with contractor representatives appropriations process agency contracting process and invoice reconciliation for all vendor contracted activities affecting the pharmacy department. These programs include but are not limited to: State Maximum Allowable Cost Prior Authorizations and Drug Utilization Review.

• Develops operationalizes and assists in the development of a disease and medication therapy management program. This function may include policy development State Plan Amendments CMS waivers administrative rules rate-setting the RFP process provider and vendor contracts budgeting and monitoring.

• Collaborates with Managed Care plans for oversight implementation and evaluation of the SoonerSelect Pharmacy program.

• Interacts with SoonerCare members regarding prescription issues while working toward resolution.

• Consults with provider pharmacists and physicians related to the pharmacy program.

• Consults/supports agency departments regarding pharmacy issues.

• Represents OHCA regarding pharmacy issues with external stakeholders and at various meetings.

• Other duties as assigned.

This position requires a thorough understanding of pharmacy program operations Medicaid programs such as SoonerCare and changes in the pharmaceutical industry and their impact on healthcare delivery systems. Key qualifications include a strong technical aptitude and database familiarity with advanced skills in clinical data querying Excel andclaims analysisto evaluate system edits and program trends. Candidates must possess expertise inpolicy development budget planning and vendor contract negotiation along with the ability to establish and maintain effective relationships with stakeholders analyze and resolve complex pharmacy issues and design member and provider intervention programs. Success in this role requires strong communication collaboration and strategic decision-making to optimize work processes and drive cost-effective resource use. Additionally candidates must demonstrateaccountability financial acumen and the ability to manage complexitywhile fostering collaboration embracing new technology and ensuring program compliance.

**To be considered for this position your application must include a resume/CV with complete work and education history.**

• Valid license to practice pharmacy in the State of Oklahoma plus 3 years of experience as a pharmacist OR

• A PhD in Pharmaceutical Services and a valid license to practice pharmacy in the State of Oklahoma

• Strong technical and data analytics proficiency including experience withExcel reporting tools ( Objects) or healthcare database querying.

• Experience with or aptitude for pharmacy claims analysisMMIS Drug Utilization Review (DUR) or pharmacy benefit management (PBM) platforms.

• Proven ability to quickly learn complex software systems claims processing rules and technical workflows.

• Knowledge of Medicaid programs (such asSoonerCare / SoonerSelect) and managed care pharmacy operations.

Work is typically performed in an office setting with climate-controlled settings and exposure to moderate noise levels. In the course of performing job duties employees are required to speak stand walk and reach with their hands and arms. This position requires extended periods of sitting and daily use of computers and phones. Employees must be willing to complete all job-related travel associated with this position. Being present at the office is an essential function of this position.

The Oklahoma Health Care Authority complies with applicable State and Federal civil rights laws and does not discriminate. All qualified applicants will receive consideration for employment without regard to race color sex religion disability age national origin or genetic information. If a reasonable accommodation is needed to participate in the job application or interview process to perform essential job functions and/or to receive other benefits and privileges of employment please contact the Civil Rights Coordinator at .

Notice to applicants:

Please add to the address book or safe-senders list in your email. All correspondence will come from this address. Be sure to check your junk folder. If you have questions about the status of your application you can contact the HR team at .

Note: Applications will be accepted until 11:59 PM on the day prior to the posting end date above.

Current State of Oklahoma employees must apply for open positions internally through WorkdayJobs Hub.