Pharmacy Management Consultant - Indianapolis Health

Overview

Milliman's Indianapolis Health Practice is looking for a Pharmacy Management Consultant to provide support to our internal Medicaid pharmacy consultants and state Medicaid actuarial teams by serving as a Medicaid pharmacy subject matter expert as it relates to pharmacy program changes, drug pricing trends, and managed care efficiencies that are critical in the development of managed care capitation rates. In addition, the Pharmacy Management Consultant will serve as a strategic advisor to State Medicaid agencies to evaluate pharmacy reimbursement, benefit design, performance, and financial oversight of the Medicaid pharmacy program.

Responsibilities

In this role, you will leverage clinical and financial pharmacy knowledge to:

• Diagnose and solve client problems in Medicaid managed care and fee-for-service settings
• Develop and manage internal and external client relationships within large matrix organizations
• Design and deliver consultative support to clients by developing proposals, creating presentations, and delivering recommendations to clients
• Serve as a subject matter expert of pharmacy benefit financing and administration in Medicaid and other public sector healthcare programs
• Develop and maintain drug lists used in analyses and monitoring reports such as new drug approvals, new indications, first-time generics, drug pricing changes, and specialty and high-cost drugs
• Model the impact to drug utilization and cost resulting from changes, or proposed changes to preferred drug lists or pharmacy benefit design
• Identify diagnosis codes relevant to certain clinical conditions or drugs for use in analyses
• Developing methodologies, analyses, and client deliverables

Qualifications

• Experience working with state agency clients, preferably in Medicaid or health and human services
• Deep domain knowledge of pharmacy benefit financing and administration in the public sector including preferred drug lists, pharmacy carve-outs, pharmacy utilization and expenditure analysis, pricing models, and regulations such as 340B
• Critical thinking and analytical skills, preferably combined with technical skills
• Experience working with large pharmacy claims and referential data sets
• Ability to work in Microsoft Office, specifically Excel and Word
• Attention to detail ensuring high accuracy and quality
• Ability to manage and prioritize concurrent work across multiple projects
• Self-motivated and ability to work independently recognizing when to ask questions or escalate issues
• Strong sense of accountability and business acumen

Required

• Bachelor's or Doctor of Pharmacy degree
• Active pharmacist license
• 5+ years of experience in pharmacy benefit financing and administration in the public sector, preferably at a consulting firm, managed care organization, or health plan

The Team

The Indianapolis Health Practice is strategically structured to serve state Medicaid and other health and human service agencies. Our team consults with state Medicaid agencies advising our clients on pharmacy reimbursement strategies, benefit design, performance, and financial oversight of the pharmacy program. Our services are comprised of performing analyses to conduct comprehensive program reviews to assess the management and performance of the core components in administration of the Medicaid pharmacy benefit. We also provide validation and assessment of claims data quality, reimbursement rate evaluations and strategy, and policy and contracting support. You will work in a matrix environment, learning from seasoned consultants and gaining exposure to projects across a range of states and agency types. As a member of this team, you will observe how we provide comprehensive consulting services which span from many different disciplines and backgrounds including actuarial, policy, finance, pharmacy, and data management, all working together for a common goal to best serve our clients' needs. We offer challenging projects, expert colleagues, a collaborative environment, and diverse client projects for all employees to work, learn, and grow with our practice.

Location

The person hired for this role will work in a dynamic, hybrid environment, with 2 to 3 days per week of on-site work required in our Indianapolis office on a weekly basis.

Compensation

The salary range for this role is 118,000 - $185,000, depending on a combination of factors, including, but not limited to, education, relevant work experience, qualifications, skills, certifications, location, etc.

Benefits

At Milliman, we focus on creating an environment that recognizes - and meets - the personal and professional needs of the individual and their family. We offer competitive benefits which include the following based on plan eligibility:

• Medical, dental and vision coverage for employees and their dependents, including domestic partners
• A 401(k) plan with matching program, and profit sharing contribution
• Employee Assistance Program (EAP)
• A discretionary bonus program
• Paid Time Off (PTO) starts accruing on the first day of work and can be used for any reason; full-time employees will accrue 15 days of PTO per year, and employees working less than a full-time schedule will accrue PTO at a prorated amount based on hours worked
• Family building benefits, including adoption and fertility assistance and paid parental leave up to 12 weeks for employees who have worked for Milliman for at least 12 months and have worked at least 1,250 hours in the preceding 12-month period
• A minimum of 8 paid holidays
• Milliman covers 100% of the premiums for life insurance, AD&D, and both short-term and long-term disability coverage
• Flexible spending accounts allow employees to set aside pre-tax dollars to pay for dependent care, transportation, and applicable medical needs

Who We Are

Independent for 75 years, Milliman delivers market-leading services and solutions to clients worldwide. Today, we are helping companies take on some of the world's most critical and complex issues, including retirement funding and healthcare financing, risk management and regulatory compliance, data analytics and business transformation.

Milliman invests in skills training and career development, and gives all employees access to a variety of learning and mentoring opportunities. Our growing number of Milliman Employee Resource Groups (ERG's) are employee-led communities that influence policy decisions, develop future leaders, and amplify the voices of their constituents. We encourage our employees to give back to their varied professions, including leadership in professional organizations. Please visit our web site (https://www.milliman.com/en/social-impact) to learn more about Milliman's commitments to our people, diversity and inclusion, social impact and sustainability.

Through a team of professionals ranging from actuaries to clinicians, technology specialists to plan administrators, we offer unparalleled expertise in employee benefits, investment consulting, healthcare, life insurance and financial services, and property and casualty insurance.

Equal Opportunity

All qualified applicants will receive consideration for employment, without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, or status as a protected veteran.

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