Regulations & Contracts Pharmacy Manager - Hybrid

Under the direction of the Pharmacy Operations Manager, the Regulations & Contract Pharmacy Manager is responsible for managing and updating policies,regulations and contracts for the MassHealth Pharmacy program.

Advises MassHealth units about contract language to incorporate pharmacy-related requirements into various contracts. Work with other pharmacy staff and legal staff to develop the language.
Develops and leads projects to implement federal and state regulations and policies about medications delivered to MassHealth members in a variety of settings (pharmacies and physician-administered, Health Safety Net, FFS Medicaid and managed care).
Regularly review and update pharmacy policies procedures and regulations as needed.
Perform environmental scans to determine current pharmacy policies and practices among state Medicaid agencies, the Federal Center for Medicare and Medicaid Services (CMS), and commercial payers to support policy decisions that are up-to-date and consistent with national trends.
Manages and provides overall direction to project teams, which may consist of internal and external stakeholders, for the development of project statements, work plans, report analyses, communication plans, and contract deliverables.
Identifies necessary resources to perform program work, monitors work progress including, data analysis and report development, and oversees its timely completion.
Communicates with state agency staff and other external stakeholders in creating and implementing appropriate program designs and work plans, convening team meetings as appropriate.
Manages day-to-day logistics and operational needs of the projects or programs, which may require interface with internal/external senior staff.
Serves as a liaison with state partners and clients, as needed, to facilitate operational project success.
Serves as pharmacy representative on internal or external workgroups
Participates in preparing financial analyses as required.
Advises MassHealth units about contract language to incorporate pharmacy-related requirements into various contracts. Work with other pharmacy staff and legal staff to develop the language.
Develops and leads projects to implement federal and state regulations and policies about medications delivered to MassHealth members in a variety of settings (pharmacies and physician-administered, Health Safety Net, FFS Medicaid and managed care).
Regularly review and update pharmacy policies procedures and regulations as needed.
Perform environmental scans to determine current pharmacy policies and practices among state Medicaid agencies, the Federal Center for Medicare and Medicaid Services (CMS), and commercial payers to support policy decisions that are up-to-date and consistent with national trends.
Participates in program and business development, as assigned.
Participates in performance improvement initiatives and demonstrates the use of quality improvement initiatives within operations.
Interfaces with Human Resources Department on personnel related issues as needed, including participating in recruitment, interviewing , and hiring of staff.
Performs other duties as assigned.

REQUIRED EDUCATION
Master’s degree in Business Administration, Health Care Administration, Public Health, or a health policy related care field, or equivalent relevant experience.
REQUIRED WORK EXPERIENCE
Proven ability to lead and direct a matrix project team, as well as the ability to lead and direct effective meetings and work sessions.
Strong written and verbal communication skills to interact effectively with staff, clients and vendor staff.
Ability to produce reports suitable for both an academic and a public sector audience.
Strong computer skills, including word processing, spreadsheets, and PowerPoint.
Ability to travel to off-site locations.

PREFERRED WORK EXPERIENCE
Experience working in and/or with the public sector and State Medicaid strongly preferred.

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