Benefit Program Senior Specialist

State of Missouri; Jefferson City (MO); On-site; USD 44,000 - 53,000; Full time

Job summary

The State of Missouri MO HealthNet Division seeks a Benefit Program Senior Specialist for the Medicaid Drug Rebate Unit in Cole County. Based in Jefferson City, this role handles pharmaceutical manufacturer accounts, disputes, recoupment actions, and data analysis to support MDRP compliance.

Responsibilities include routine reporting, reviewing payment data, and coordinating with providers and manufacturers. Strong planning, communication, and pharmaceutical experience are preferred.

Qualifications

• Bachelor’s degree and 1-3 years of relevant experience. (Substitutions may be allowed.)
• Experience within a pharmaceutical setting and experience with collections are preferred.
• Good written and verbal communication skills.

Responsibilities

• Manage pharmaceutical manufacturer accounts as assigned.
• Resolve disputes submitted by pharmaceutical manufacturers in response to invoices generated from drug claims data.
• Prepare routine reports and documentation needed to reconcile pharmaceutical manufacturer outstanding balances.
• Analyze and evaluate claims to identify patterns of utilization to recognize possible abuse or errors in claim filing.
• Review and evaluate detailed payment data from reports to identify and initiate recoupment/adjustment of claims.
• Monitor CMS MDRP compliance and related regulations.
• Answer program inquiries from providers and pharmaceutical manufacturers.
• Locate, organize, and analyze information related to the MDRP.
• Communicate program requirements to manufacturers, providers and co-workers.
• Participate in meetings to identify problems and develop solutions.

Skills

Communication skills

Planning & prioritization

Pharmaceutical experience

Collections experience

Claims data analysis

Education

Bachelor’s degree

Job description

The MO HealthNet Division has an opening for a Benefit Program Senior Specialist within the Medicaid Drug Rebate Unit located in Cole County.

Semi-monthly salary: The current rate for this position is $2,020.69. Individual(s) selected for this position may receive a higher rate based on a pay differential (e.g. shift, or time-of-service pay).

Annual Salary: $48,496.56

Job Posting Number: 4591 8260011

Job Location: This position is located at the Howerton State Office Building; 615 Howerton Court, Jefferson City, MO.

The Department of Social Services partners with families and communities to protect children, rehabilitate youth and move families to self-sufficiency so that Missourians can lead safe, healthy and productive lives.

Why you’ll love this position: This position is in a small unit of 9 staff members who work closely together to collect rebates from pharmaceutical manufacturers. The work can be challenging but the rewards are big as the funds collected largely impacting the overall budget for MO HealthNet.

What You’ll Do

• Manage pharmaceutical manufacturer accounts as assigned.
• Resolve disputes submitted by pharmaceutical manufacturers in response to invoices generated from drug claims data.
• Prepare routine reports and documentation needed to reconcile pharmaceutical manufacturer outstanding balances.
• Analyze and evaluate claims to identify patterns of utilization to recognize possible abuse or errors in claim filing.
• Review and evaluate detailed payment data from reports in order to identify and initiate recoupment and/or adjustment of claims.
• Monitor unit and program operations, regulations, procedures and audit recommendations to ensure compliance with Centers for Medicare and Medicaid Services (CMS) for the Medicaid Drug Rebate Program (MDRP).
• Answer program inquiries from providers and pharmaceutical manufacturers.
• Locate, organize, and perform routine analysis on information from various sources pertaining to all aspects of the Medicaid Drug Rebate Unit.
• Communicate effectively with manufacturers, providers and co-workers regarding program requirements related to the MDRP.
• Participate with other staff members in meetings to identify problem areas and develop solutions; and perform other related work as assigned

Minimum Qualifications

Bachelor’s degree and 1-3 years of relevant experience. (Substitutions may be allowed.)

Preferred Qualifications

• Experience within a pharmaceutical setting (working as a pharmaceutical technician or billing pharmaceutical claims)
• Experience with collections
• Ability to plan, organize and prioritize work
• Good written and verbal communication skills

Lack of post-secondary education will not be used as the sole basis denying consideration to any applicant.

The State of Missouri offers an excellent benefits package that includes a defined pension plan, generous amounts of leave and holiday time, and eligibility for health insurance coverage. Your total compensation is more than the dollars you receive in your paycheck. To help demonstrate the value of working for the State of Missouri, we have created an interactive Total Compensation Calculator. This tool provides a comprehensive view of benefits and more that are offered to prospective employees. The Total Compensation Calculator and other applicant resources can be found here.

If you have questions about this position, please contact: Jaime Jones at [e-mail] . If you experience accessibility issues while applying, please contact Courtney Hall at [e-mail].

Recruitment Area

All qualified applicants.

Application Deadline

October 5, 2026