Pharmacy Policy and Program Specialist

State of Iowa - Executive Branch; Des Moines (IA); Presencial; USD 70.000 - 100.000; Jornada completa

Ventajas ofrecidas por este puesto de trabajo

Health, Dental, and Vision Coverage

Paid Time Off (96+ hours to start)

IPERS Retirement Plan

Flexible Spending Accounts

Life Insurance & Disability

Employee Assistance Program

Employee Discount Programs

Descripción de la vacante

The State of Iowa - Executive Branch is seeking a policy-focused professional to guide and strengthen pharmacy benefit operations for PAD and OPD. This role serves as a policy and program expert, ensuring compliant implementation of federal and state requirements while coordinating with legal, finance, data, and other internal partners.

You will analyze claims, support 340B and Drug Rebate compliance, and draft essential administrative rules.

Formación

• Seven years of full-time work experience in administration or operation/execution of a program.
• Graduate/alternative combinations of education and experience may apply per the listed options.
• Graduation from an accredited school of law is required or strongly preferred.
• Current, continuous experience in the state executive branch with specific Program Planner history is noted.

Responsabilidades

• Guide and strengthen pharmacy benefit operations for PAD and OPD benefits.
• Manage policy functions, evaluate MCO pharmacy performance and reviewer deliverables.
• Analyze claims and utilization trends; support 340B and Drug Rebate compliance.
• Draft administrative rules and communications; coordinate complex inquiries and regulatory requests.
• Prepare leadership briefings and collaborate with legal, finance, data, and program integrity teams.

Conocimientos

Policy analysis

Cross-functional coordination

Regulatory compliance

Attention to detail

Educación

Law degree

Descripción del empleo

Job Description

The Iowa Medicaid program is seeking a detail-oriented, policy-focused professional to guide and strengthen our pharmacy benefit operations. This role serves as a policy and program expert for the Physician Administered Drug (PAD) and Outpatient Prescribed Drug (OPD) benefits, ensuring consistent, compliant, and high-quality implementation of federal and state requirements.

The Iowa Medicaid program is seeking a detail-oriented, policy-focused professional to guide and strengthen our pharmacy benefit operations. This role serves as a policy and program expert for the Physician Administered Drug (PAD) and Outpatient Prescribed Drug (OPD) benefits, ensuring consistent, compliant, and high-quality implementation of federal and state requirements. In this position, you will manage key policy functions, evaluate Managed Care Organization (MCO) pharmacy performance, and review Pharmacy Benefits Administrator deliverables to ensure alignment with Medicaid standards. You will analyze claims and utilization trends, support 340B and Drug Rebate regulatory compliance, maintain accurate benefit documentation, and draft essential administrative rules and communications. The Program Planner 3 plays a central role in coordinating responses to complex inquiries, appeals, and regulatory requests; guiding coding alignment activities; preparing briefings for leadership; and collaborating closely with legal, finance, data, program integrity, and other internal partners to resolve issues and support optimal member and provider outcomes. If you excel at interpreting complex policy, managing cross-functional coordination, and ensuring operational consistency in a fast-moving health policy environment,

Benefits

Working for the State of Iowa comes with its perks. In addition to a competitive salary, you'll enjoy a comprehensive benefits package designed to support your well-being and professional growth:

• Health, Dental, and Vision Coverage: Health and dental insurance packages to keep you and your family healthy at a low cost with outstanding coverage!
• Paid Time Off: Take time to recharge with paid time off, including vacation (96 hours/year to begin, increasing with years of service), sick leave (144 hours/year), and paid holidays (9 days/year).
• Retirement Plans: Participate in retirement plans such as IPERS (employees contribute 6.29% and the State of Iowa contributes 9.44%) as well as our Retirement Investors Club (RIC), Employer Sponsored Retirement Plan (the State of Iowa matches dollar for dollar up to $75/month).
• Flexible Spending Accounts: Take advantage of flexible spending accounts for medical and dependent care expenses.
• Insurance Coverage: Benefit from life insurance and free long-term disability insurance for added peace of mind.
• Employee Assistance Program: Access resources and support through our Employee Assistance Program for personal and professional challenges.
• Employee Discount Programs: Enjoy discounts on a variety of goods and services through our employee discount programs.

Background Checks

Applicants will be required to complete a background check to be considered for this position.

The State of Iowa is an EEO/AA Employer

HHS values those with “lived experience” and encourages adults who were fostered as youth, foster parents, and/or parents who were in the DHS system to apply. Minorities, women, persons with disabilities and veterans are encouraged to apply (Hearing and Speech Impaired – Relay Iowa 1-800-735-2942 TDD).

E-Verify and Right to Work

The State of Iowa participates in E-Verify, a federal program that helps employers confirm the employment eligibility of all newly hired employees. Within the required timeframe, new hires will be verified through the E-Verify system to ensure authorization to work in the United States. The State of Iowa also complies with the federal Right to Work laws, which protect employees’ rights to work without being required to join a labor organization. For more information, please visit www.e-verify.gov.

All work performed on behalf of Iowa Health and Human Services must occur in the State of Iowa.

Minimum Qualification Requirements

Applicants must meet at least one of the following minimum requirements to qualify for positions in this job classification:

• Seven years of full-time work experience in the administration or operation/execution (i.e., providing consultation and/or technical assistance to stakeholders, research and analysis, or enforcement of program guidelines/policies/procedures) of a program (i.e., the provision of a service or an administrative oversight/enforcement responsibility).
• All of the following (a, b, and c):
• One year of full-time work experience in the administration or operation/execution (i.e., providing consultation and/or technical assistance to stakeholders, research and analysis, or enforcement of program guidelines/policies/procedures) of a program (i.e., the provision of a service or an administrative oversight/enforcement responsibility); and
• A total of four years of education and full-time experience (as described in part a), where thirty semester hours of accredited college or university course work in any field equals one year of full-time experience;
• A total of two years of graduate-level education and full-time experience (as described in part a), where twenty-four semester hours of accredited graduate college or university course work in any field equals one year of full-time experience.
• Graduation from an accredited school of law.
• Current, continuous experience in the state executive branch that includes nine months of full-time work as a Program Planner 2 or twenty-seven months of full-time work as a Program Planner 1.