Medicaid Pharmacy Policy & Compliance Lead

State-of-Iowa; Des Moines (IA); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

Health, Dental, and Vision Coverage

Paid Time Off

Retirement Plans (IPERS / RIC)

Flexible Spending Accounts

Life insurance

Employee Assistance Program

Employee Discount Programs

Job summary

The State of Iowa seeks a detail-oriented Program Planner 3 to guide and strengthen our pharmacy benefit operations, focusing on the Physician Administered Drug (PAD) and Outpatient Prescribed Drug (OPD) benefits, ensuring compliant implementation of federal and state requirements.

You will evaluate MCO pharmacy performance, review Pharmacy Benefits Administrator deliverables, analyze claims and utilization trends, and draft essential administrative rules and communications, coordinating with

Qualifications

• Seven years of full-time work experience in the administration or operation/execution of a program.
• One year of experience plus educational requirements as described, combining education and work.
• Graduation from an accredited school of law.

Responsibilities

• Guide and strengthen pharmacy benefit operations for PAD/OPD to ensure compliant implementation.
• Evaluate MCO pharmacy performance and review Pharmacy Benefits Administrator deliverables.
• Analyze claims and utilization trends; support regulatory compliance and benefit documentation.
• Draft essential administrative rules and communications; coordinate with legal, finance and data teams.

Education

Graduation from an accredited law school

Job description

The State of Iowa seeks a detail-oriented Program Planner 3 to guide and strengthen our pharmacy benefit operations, focusing on the Physician Administered Drug (PAD) and Outpatient Prescribed Drug (OPD) benefits, ensuring compliant implementation of federal and state requirements.

You will evaluate MCO pharmacy performance, review Pharmacy Benefits Administrator deliverables, analyze claims and utilization trends, and draft essential administrative rules and communications, coordinating with