What are the responsibilities and job description for the Pharmacy Provider Fee Specialist position at State of Louisiana?
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- Initiates, coordinates, and maintains all aspects of the pharmacy provider fee program.
- Communicates and collaborates with state agencies, pharmacy providers, specific LDH departments, legislators, LA Board of Pharmacy, and advocacy groups.
- Reviews Medical Assistance Trust Fund (MATF) waiver requests from pharmacies.
- Manipulates, analyzes, and interprets large groups of data sets.
- Works independently and efficiently.
- Creates policy and procedures around provider fee process including the LDH fiscal department.
- Performs reconciliation of quarterly payment.
- Collaborates with other State agencies to consider potential benefits that could be derived from establishing an all-payers claims data base, which would be inclusive of claims data from public and private payers.
- Reviews the statutory language and sets clear standards for which out?of?state providers have to submit the provider fee, as well as noncompliant pharmacies.
- Coordinates between agencies and reports to utilize a common identifier for pharmacies.
- Compares quarterly provider fee reports and trend data over time to recognize changes to reporting, and researches the differences from previous quarters.
- Provides education to pharmacy providers regarding the provider fee requirements.
- Communicates with the Louisiana Department of Insurance when Pharmacy Benefit Managers (PBM) are found to be non-compliant with Louisiana Revised Statute 46:2625.
- Other tasks as directed.
QUALIFICATIONS
REQUIRED:
- Bachelor’s Degree or Associate’s degree plus 3 years of professional experience, or 6 years of professional work experience.
- Minimum three years professional experience in data/statistical analytics, and reporting.
- Minimum three years professional experience utilizing data visualization tools.
- Minimum three years of professional experience in managing projects and coordinating on multi-agency projects.
- Strong verbal and written communications skills and ability to communicate technical concepts to technical and non-technical audiences.
- Excellent analytical, problem-solving, organizational and time management skills.
- Great attention to detail and follow up, and strong verbal/written communications skills.
- Works well both independently and as part of a team.
- Ability to set, follow, and meet deadlines.
- Proficient in the use of Microsoft Office Suite (Word, Excel, PowerPoint, Access and Outlook).
DESIRED:
- Advanced degree in computer science, Health Informatics, or related field.
- Minimum 4 years of practical experience in data/statistical analytics and reporting.
- Minimum 4 years of professional experience utilizing data visualization tools.
- Minimum 4 years of professional experience in managing projects and coordinating on multi-agency projects.
- Minimum 1 year professional experience with general accounting principles.
