Director of Plan Operations - Pharmacy Benefits

State of North Carolina; North Carolina; On-site; USD 85,000 - 115,000; Full time

Job summary

The State of North Carolina is seeking a Director of Plan Operations for the NC State Health Plan. This leadership position involves managing pharmacy benefits and operations, developing processes to maximize subsidies, and ensuring compliance with contracts. Candidates must hold a relevant degree and have significant experience in pharmacy services within healthcare settings.

Benefits

Health insurance

Paid vacation

Retirement benefits

Qualifications

• Seven years of progressive experience in Pharmacy services.
• Three years in pharmacy benefit manager vendor contract compliance and oversight.

Responsibilities

• Oversight of pharmacy benefit programs and contracts.
• Development of operational processes to ensure subsidy receipt.
• Implementation of pharmacy RFP/contracts.

Skills

Pharmacy services

Contract compliance

Benefit design

Education

Bachelor’s degree in a related field

Job description

*** This is a repostingcurrent applicants Do Not have to re-apply.***

The NC State Health Plan is hiring a Director of Plan Operations to manage the Plan's Pharmacy Benefits Manager (PBM) Contract, pharmacy operations, the Employer Group Waiver Plans (EGWP) program, and EGWP enrollment. This is a full-time position (40 hours per week) withState Benefits, including health insurance, paid vacation, paid sick time, paid holidays, as well as retirement.

This position has been designated as Exempt in accordance with North Carolina General Statute § 126-5 (c1)(c23) (24).

About the State Health Plan
The North Carolina State Health Plan for Teachers and State Employees, a division of the Department of State Treasurer, provides health care coverage to more than 740,000 teachers and local school personnel, state employees, retirees, current and former lawmakers, state university and community college faculty and staff, and their dependents.

ThePlan Operations Teamsteam provides operational oversight for the Plan’s contract administration with the third-party administrator, pharmacy benefit manager, enrollment and eligibility, billing, and other related services vendors.

Responsibilities

• Development and oversight of pharmacy RFP/contracts.
• Implementation and management of pharmacy benefit programs.
• Develop, implement, and manage operational processes to ensure maximum receipt of retiree drug subsidy (RDS) or other Part D programs such as employer group waiver plans (EGWP).
• Develops programs and benefit designs in collaboration with other SHP leadership and in accordance with the Board of Trustee’s strategic plan.

In furtherance of the Department of State Treasurer's existing ethics and transparency programs, this position is subject to the ethics and conflict of interest requirements of the Department of State Treasurer Supplemental Ethics Policy (Tier 2 Ethics Policy).(https://www.nctreasurer.com/documents/files/slgfdworksheets/dstpolicies/supplemental-ethics-policy-tier-2/download?attachment).Qualified applicants must possess, and application must clearly reflect work experience that demonstrates the following:

• Experience facilitates audits of the pharmacy benefit manager to ensure processing.

• Experience developing and implementing policies and programs in keeping Plan goals to include, development of cost-effective benefit design.

• Experience developing, implementing and managing operational processes to ensure receipt of retiree drug subsidy (RDS) or Part D programs.

Some state job postings say you can qualify by an “equivalent combination of education and experience.” If that language appears below, then you may qualify through EITHER years of education OR years of directly related experience, OR a combination of both. See oshr.nc.gov/experience-guide for details.

Bachelor’s degree in an appropriate field of study with seven (7) years of progressive experience in Pharmacy services in a health care environment and a minimum of three (3) years in pharmacy benefit manager vendor contract and compliance.

* PLEASE SUBMIT YOUR APPLICATION ON-LINE USING THIS WEBSITE *

This position is subject to a criminal history background check through CastleBranch. In addition, one or more of the following may also be reviewed, depending on the nature and requirements of the position: employment history, professional references, credit history, and educational verification (i.e., degree, license, or official transcript). Applicants will be required to pass the background check to the satisfaction of the North Carolina Department of State Treasurer. All offers of employment are conditional until the satisfactory completion of the background check.

This office uses the Merit-Based Recruitment and Selection Plan to fill positions with highly qualified individuals. All applicants must complete and submit a State application for employment using the NEOGOV Online Job Application System (OSHR - Work for NC) for the State of North Carolina.To receive credit for your work history and credentials, you must list the information on the online application form. Any information omitted from the application cannot be considered in screening for qualifying credit. Attached or incorporated resumes (including Text resumes on application form) WILL NOT be used for screening for qualifying credit. Please make sure you complete the application in full.For additional information about applications and processes with the state of NC Please visit:How Do I Get the Job

The State of North Carolina, and the Department of State Treasurer, is an Equal Opportunity Employer:

• Applicants requesting and receiving an accommodation under the Americans with Disabilities Act (ADA) are eligible to submit paper applications via mail or by fax reference the contact information below. All applicants should indicate the position number and job title in the section "Jobs Applied For".
• Applicants seeking Veteran's Preference must attach a DD 214 Form, Certificate of Release or Discharge from Active Duty along with your application.
• Applicants seeking National Guard Preference
  • North Carolina Army National Guard
  • North Carolina Air National Guard
    • Must attach a copy of the NGB 23A (RPAS) or a copy of the DD256 or NGB 22 along with your application.

"See Resume" or "See Attachment" will NOT be accepted and will be considered an incomplete application and will not be processed. Other attachments will also be accepted, but not used in screening for qualifying credit.

Please note, foreign degrees require an official evaluation for U.S. equivalency, and must be submitted to Human Resources for verification. There are several organizations that perform this specialized service, feel free to use any service of your choosing. For your convenience a couple are listed below:

• International Education Research Foundation - [phone] or www.ierf.org
• World Education Services Inc. - [phone] or www.wes.org

Due to the volume of applications received, we are unable to provide information regarding the status of your application over the phone. To check the status of your application, please log in to your account and click "Application Status". It is not necessary to contact the Human Resources Office to check the status of an application.

If you are having technical issues submitting your application, please call the NeoGov Help Line at 855-524-5627. If there are any questions about this posting, other than your application status, please email Department of State Treasurer [e-mail].