Pharmacy Policy and Program Specialist

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 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, we welcome your application!

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.

For additional information on benefits click here.

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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.

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

• 1) 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).
• 2) All of the following (a, b, and c):
  • a. 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
  • b. 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; and
  • c. 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.
• 3) Graduation from an accredited school of law.
• 4) 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.

For additional information, please click on this link to view the job description.