Pharmacy Program Specialist

Montana Department Of Public Health And Human Services (Dphhs)

2+ years

$ 32.09 Hourly

Remote

10 Nov. 5, 2024

Job Description

Job Type: Full Time Education: B.Sc./ M.Sc./ M.Pharm/ B.Pharm/ Life Sciences Skills: Causality Assessment, Clinical SAS Programming, Communication Skills, CPC Certified, GCP guidelines, ICD-10 CM Codes, CPT-Codes, HCPCS Codes, ICD-10 CM, CPT, HCPCS Coding, ICH guidelines, ICSR Case Processing, Interpersonal Skill, Labelling Assessment, MedDRA Coding, Medical Billing, Medical Coding, Medical Terminology, Narrative Writing, Research & Development, Technical Skill, Triage of ICSRs, WHO DD Coding

Program Specialist - Health Resources Division

Agency: Montana Department of Public Health and Human Services (DPHHS)
Location: Helena, Montana
Employment Type: Full-Time
Salary: $32.09 per hour

About the Montana Department of Public Health and Human Services (DPHHS):

The Health Resources Division of the Montana Department of Public Health and Human Services (DPHHS) is dedicated to improving the health of low-income and disabled Montanans through Medicaid and the Healthy Montana Kids (HMK) Plan. We are committed to serving the people of Montana with meaningful, community-driven work that improves health, safety, and well-being.

At DPHHS, you’ll have the opportunity to grow your career, participate in public service, and make a direct impact on the lives of Montanans in your community. The State of Montana offers comprehensive benefits, including healthcare, retirement plans, paid leave, work/life balance, and eligibility for the Public Service Loan Forgiveness (PSLF) program.

Position Overview:

The Program Specialist will be responsible for the management of the Outpatient Prescription Drug and Home Infusion Therapy Programs. This position will also oversee administrative rules, statutes, and policies related to claims payment systems and coding, providing support to Medicaid members and providers. The role involves working with program data systems (MMIS) and pharmacy point-of-sale systems, managing program contracts, and ensuring the smooth delivery of health services to members.

Key Responsibilities:

Program Management: Oversee and manage the Outpatient Prescription Drug and Home Infusion Therapy Programs, ensuring compliance with Medicaid regulations and policies.
Claims and Billing Support: Work with members and healthcare providers regarding services, billing inquiries, and case management.
Policy Interpretation: Research, interpret, and apply laws, regulations, and administrative rules related to Medicaid, medical billing, and pharmacy programs.
System Coordination: Facilitate necessary updates and modifications to the Montana Medicaid Information System (MMIS) and pharmacy point-of-sale systems.
Contract Management: Manage and monitor program contracts, ensuring that all requirements are met.

Qualifications:

Required Education: Bachelor’s degree in human services, business, public or health administration, or a related field.
Experience: Two years of progressively responsible administrative or program experience.
Preferred Experience: Experience with Medicaid, pharmacy, or other care-related programs. Active Pharmacy Technician Certification (BPTS or PTCB) is preferred but not required.
Skills and Abilities:
- General knowledge of Medicaid, medical terminology, and billing practices.
- Ability to research, interpret, and apply laws, rules, and regulations.
- Strong written and verbal communication skills.
- Knowledge of program management principles and practices.

How to Apply:

To apply for this position, submit the following required documents through the State of Montana Careers website:

Cover Letter
Resume
References

Ensure that all documents are properly attached by checking the "relevant document" box during submission.

Additional Information:

Telework: This position may be eligible for partial telework within the state of Montana. Specific conditions will be provided by the supervisor.
Salary: $32.09 per hour.
Benefits: Health insurance, paid leave, holidays, retirement plan, and other state benefits.
Employee Status: Regular, full-time position.
Travel: 5% of the time.
Union Status: Montana Federation of Public Employees (MFPE).

Contact Information:

For questions or more information, contact Shandee Cook at:

Email: shandee.cook2@mt.gov
Phone: 406-444-0962

Equal Opportunity Employer:

Mumbai

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