Pharmacy Management Consultant - Indianapolis Health

About the position

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

• 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
• Develop methodologies, analyses, and client deliverables

Requirements

• 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

Benefits

• 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