Management Analyst III

TX-HHSC-DSHS-DFPS•Austin, TX

11d•$5,099 - $8,305•Hybrid

About The Position

The Texas Health and Human Services Commission (HHSC) Medicaid and CHIP Services (MCS) Department seek a highly qualified candidate to fill the position of Management Analyst III on the Vendor Drug Program (VDP) DUR and Formulary Management team. This position reports to the Director of DUR and Formulary Management and serves as a resource and subject matter expert (SME) for this area. The Management Analyst III performs advanced (senior level) professional organizational analysis work. Works under limited supervision, with considerable latitude for the use of initiative and independent judgment. This position will be responsible for the addition, deletion, and changes in product or reformulation for single source, over the counter (OTC), and generic drugs as well as non-drug products on the Texas formularies. This position will assist with planning, implementing, and designing changes in the contractor’s claims adjudication system and has the primary responsibility for production and review of documents and reports. This requires that program knowledge be combined with skills and “real world” experience to maintain a high level of competence and service. The Management Analyst III will serve as a liaison to pharmaceutical manufacturers and pharmacy providers, interpreting department policies, rules, and regulations. This position will develop new or modify existing operational program policies, procedures, goals, and objectives. This position provides advanced-level coordination and collaboration with internal and external entities and leads projects with limited notice and accelerated timelines to produce expert and diverse results. This position will allow for constant learning opportunities and a chance to impact the healthcare provided to individuals receiving Medicaid services. VDP offers a collaborative and supportive working environment. This position is eligible for teleworking, dependent on agency and division policy. This position is located in the Austin area, and candidates must reside in the Austin area.

Requirements

Graduation from an accredited four-year college or university.
Related work experience in the pharmaceutical industry (specialty, retail or hospital pharmacy), Medicaid, or managed care organization may substitute for the required education on a year-for-year basis with a maximum substitution of four (4) years.
Has experience with Microsoft products, including Word, Excel, Outlook, Teams, and SharePoint.
Knowledge of Medicaid, CHIP, state and federal legislative process, health care programs and policies.
Knowledge of pharmacy benefits provided through public or commercial insurance service delivery models, and knowledge of the pharmacy or medical industry and stakeholders.
Knowledge of local, state, and federal laws related to the Medicaid and CHIP programs.
Knowledge of government organization and administration.
Ability to gather, assemble, correlate and analyze facts; to devise solutions to problems, to provide technical assistance in preparing/editing reports; to communicate effectively, to make executive-level assignments.
Strong planning and organizational skills.
Ability to perform work with a high degree of attention to detail.
Ability to solve problems.
Ability to work with multiple levels of staff persons, and both internal and external agencies.
Ability to identify issues that present a potential risk to the Medicaid programs, Medicaid/CHIP Division or agency, including identifying political impacts.
Ability to work independently and operate effectively within established guidelines and timeframes.

Nice To Haves

Pharmacy Technician Certification (CPhT) highly preferred but not required.
Experience in writing and analyzing administrative policies, processes, standards, procedures, regulations and laws pertaining to Medicaid and CHIP outpatient drug programs.
Experience in overseeing projects through completion within deadlines.
Experience with executing high-level complex coordination, and oral/written communications, to both small and large audiences.

Responsibilities

Provides highly advanced (senior level) research, analysis, evaluation, and technical assistance in the HHSC Vendor Drug Program of Medicaid and CHIP Services.
Oversees collection, organization, analysis, and preparation of materials in response to requests for program information and reports.
Work involves planning, developing, and implementing policies and procedures, and providing analytical services related to outpatient drugs within fee for service and managed care Medicaid, consistent with federal, state laws and regulation.
Reviews, evaluates, and approves or denies single source, generic drug applications, and OTC drugs as well as non-drug products for coverage on the formularies.
Plays a critical role in the scheduled preferred drug list (PDL) implementation by reviewing, verifying, ensuring PDL changes are implemented accurately and timely.
Works closely with HHSC staff and contracted vendors to manage the formularies and preferred drug list (PDL) under the pharmacy benefit.
Provides technical assistance and guidance related to the outpatient drug benefit to other state agencies and vendors.
Provides support and program expertise to staff that oversee managed care Medicaid programs, including review of stakeholder deliverables.
Answers inquiries, interpret formulary coverage/provider policies and procedures.
Provides information to drug manufacturers, pharmacy helpdesk, pharmaceutical providers, auditors, vendors, prescribers, MCOs, recipients, other state agencies, and other HHSC program areas.
Facilitates meetings with stakeholders from all areas and levels of the agency.
Provides advanced-level coordination and collaboration with internal and external entities including contracted program vendors.
Prepares or assists in the preparation of administrative reports, studies, and specialized research projects, as requested internally and/or externally using various data sources.
Research and compiles data, per project request.
Prepares project data in Word or Excel.
Leads projects with limited notice and accelerated timelines to produce expert and diverse results.
Display strong oral and written communication skills to complete work.
Develops solutions to organizational issues and concerns, develop organizational change strategies and plans, and/or conduct training for implementation of organizational solutions, strategies, and plans related to Vendor Drug Program.
Participates in the testing and editing of claims administrator’s formulary/DUR software.
Reviews and assists in evaluating information on service delivery system methods, outputs, and activities to identify gaps in resources and recommend improvements.
Produces accurate reports.
Analyzes federal and state legislation relating to the Vendor Drug Program.
Research applicable state laws and regulations as well as federal procedures and guidelines relating to the Vendor Drug Program.
Capable of composing reports and documents suitable for legislature staff upon request.
Performs other duties as assigned and required to meet the mission and goals in Medicaid and CHIP Services.