Main Purpose of Job

This position manages the Pharmacy Services Division including all aspects of the real–time Pharmacy Claim Processing and Clinical Preauthorization/IV and High–Cost claims by utilizing professional and advanced clinical knowledge. The position also serves as the contract monitor for the Point–of–Sale Electronic Claims Management System (POSECMS) and pharmacy reimbursement methodology contracts. Furthermore, the position oversees the in–house pharmacy and provider call center operations, high–cost medications manual claims reviews, and payments and provider relations. In addition, the position reviews and approves payments related to nutritional foods for participants with metabolic disorders.

MINIMUM QUALIFICATIONS

Qualified candidates must possess a Maryland Pharmacist license with 4 years of experience as a Registered Pharmacist, including 2 years of Clinical pharmacy and/or pharmacy claims processing. Experience must include a minimum of 3–4 years of experience managing vendors, staff and administering programs.

DESIRED OR PREFERRED QUALIFICATIONS

Preferred candidates should possess the following:
3–4 years of experience managing a large contract
Training in advance pharmacy practice in pharmacotherapy
Experience performing data analytics in drug utilization trends, cost effectiveness of therapies and reimbursement methodologies

LICENSES, REGISTRATIONS AND CERTIFICATIONS

Candidates for positions in this classification must possess a current license as a Registered Pharmacist from the Maryland State Board of Pharmacy, 4201 Patterson Avenue, Baltimore, Maryland 21215.

SELECTION PROCESS

This is a Management Service position, and serves at the pleasure of the Appointing Authority. A resume must accompany your application. Applicants who meet the minimum (and selective) qualifications will be included in further evaluation. The evaluation may be a rating of your application based on your education, training and experience as they relate to the requirements of the position. Therefore, it is essential that you provide complete and accurate information on your application. Please report all related education, experience, dates and hours of work. Clearly indicate your college degree and major on your application, if applicable. For education obtained outside the U.S., any job offer will be contingent on the candidate providing an evaluation for equivalency by a foreign credential evaluation service prior to starting employment (and may be requested prior to interview). Complete applications must be submitted by the closing date. Information submitted after this date will not be added. Incorrect application forms will not be accepted. Candidates may remain on the certified eligible list for a period of at least one year. The resulting certified eligible list for this recruitment may be used for similar positions in this or other State agencies.

BENEFITS

The Maryland Department of Health offers the following benefits:
Meaningful Work
Excellent Health Benefits Package, including Medical, Vision, Prescription and Dental
Flexible Spending Accounts (Reduced Child and Health Care)
Generous Leave Benefits (6 Personal Days, 12 Regular Holidays, Annual Leave, 15 Sick Days)
Retirement
Paid Parental Leave
Flexible Work Schedules (where applicable)
Free Mass Transit (Baltimore metro area)
For a full list of the benefits of working for the State of Maryland, please click the link below:
STATE OF MARYLAND BENEFITS

FURTHER INSTRUCTIONS

Online applications are highly recommended. However, if you are unable to apply online, the paper application (and supplemental questionnaire) may be submitted to MDH, Recruitment and Selection Division, 201 W. Preston St., Room 114–B, Baltimore, MD 21201. Paper application materials must be received by 5 pm, close of business, on the closing date for the recruitment, no postmarks will be accepted. If additional information is required, the preferred method is to upload. If you are unable to upload, please fax the requested information to . Only additional materials that are required will be accepted for this recruitment. All additional information must be received by the closing date and time. For questions regarding this recruitment, please contact the MDH Recruitment and Selection Division at . If you are having difficulty with your user account or have general questions about the online application system, please contact the MD Department of Budget and Management, Recruitment and Examination Division at or . Appropriate accommodations for individuals with disabilities are available upon request by calling: or MD TTY Relay Service 1–. We thank our Veterans for their service to our country. People with disabilities and bilingual candidates are encouraged to apply. As an equal opportunity employer, Maryland is committed to recruitment, retaining and promoting employees who are reflective of the State's diversity.