Senior Medicaid Pharmacy Consultant

Selby Jennings; United States; On-site; USD 130,000 - 190,000; Full time

Job summary

Selby Jennings partners with a leading healthcare consulting organization seeking an experienced pharmacist with Medicaid pharmacy expertise to advise state agencies on policy, reimbursement, and program operations.

This role targets pharmacists with state Medicaid experience, PBMs, or government consulting; retail/hospital backgrounds are less fitting. The position offers impact on Medicaid initiatives and opportunities to shape policy.

Qualifications

• Active, unrestricted Pharmacist license (RPh).
• 5+ years in Medicaid pharmacy, government healthcare, or related policy environments.
• Direct experience supporting Medicaid programs (reimbursement, operations, policy).
• Strong analytical and communication skills with large datasets.
• Experience managing client-facing projects and multiple priorities.

Responsibilities

• Advise Medicaid and public-sector clients on pharmacy policy and reimbursement strategies.
• Lead design and evaluation of Medicaid pharmacy programs and managed care initiatives.
• Analyze healthcare data to identify trends and inform recommendations.
• Assess impact of regulatory changes on Medicaid programs.
• Manage timelines, budgets, and client communications.
• Collaborate with stakeholders across PBMs, providers, and plans.
• Support business development and thought leadership initiatives.
• Mentor junior staff and share best practices.

Skills

RPh license

Medicaid policy

Data analysis

Stakeholder management

Project management

Education

PharmD

Master's in Public Health or Policy

Tools

Excel

Job description

We're partnering with a leading healthcare consulting organization that is seeking an experienced pharmacist with deep expertise in Medicaid pharmacy programs, reimbursement, and healthcare policy. This individual will work directly with state Medicaid agencies and other public-sector healthcare organizations on initiatives that influence pharmacy benefits, program operations, managed care strategy, and reimbursement methodologies.

This role is best suited for pharmacists with experience in state Medicaid agencies, Medicaid managed care organizations, PBMs, government healthcare consulting, or Medicaid pharmacy policy and operations.

*Candidates whose backgrounds are primarily retail, hospital, or dispensing-focused pharmacy are unlikely to be the right fit*

Key Responsibilities

• Advise state Medicaid and public-sector healthcare clients on pharmacy policy, reimbursement, and operational strategy.
• Lead and support projects involving Medicaid pharmacy program design, managed care initiatives, reimbursement analysis, and regulatory compliance.
• Analyze pharmacy and healthcare data to identify trends, assess program performance, and develop actionable recommendations.
• Evaluate the impact of federal and state regulatory changes on Medicaid pharmacy programs.
• Manage project timelines, deliverables, budgets, and client communications.
• Collaborate with Medicaid leadership, managed care plans, PBMs, providers, and other stakeholders to address complex pharmacy-related challenges.
• Contribute to business development efforts, proposal creation, and strategic growth initiatives.
• Mentor junior team members and support the development of best practices, tools, and thought leadership across the organization.

Qualifications

• Active, unrestricted Pharmacist (RPh) license.
• 5+ years of experience in Medicaid pharmacy, government healthcare, managed care, PBMs, healthcare consulting, or related policy-focused environments.
• Direct experience supporting Medicaid programs, including areas such as reimbursement, pharmacy operations, policy implementation, state plan amendments, waivers, or regulatory compliance.
• Strong analytical and problem-solving skills, including experience working with large healthcare datasets and Excel-based analysis.
• Excellent communication and stakeholder management abilities.
• Proven track record managing multiple priorities and contributing to complex, client-facing projects.

Preferred Experience

• PharmD degree.
• Experience advising or consulting with state Medicaid agencies.
• Prior work within a Medicaid managed care organization, PBM, or state Medicaid program.
• Knowledge of 340B, value-based purchasing arrangements, alternative payment models, Medicaid managed care reimbursement, or pharmacy procurement initiatives.
• Experience partnering with actuaries, healthcare economists, or reimbursement teams.
• Master's degree in Public Health, Health Policy, Public Administration, Business Administration, or a related field.

This is an opportunity to help shape pharmacy policy, reimbursement strategy, and program performance for state healthcare programs while working on some of the most impactful Medicaid initiatives in the market.