Senior Medical Consultant - Pharmacist

Company:

Mercer

Description:

We are seeking a talented individual to join our Government Human Services Consulting  team at Mercer.  This is a hybrid role that has a requirement of working at least three days a week in the office.

Senior Medical Consultant - Pharmacist

•  The Senior Medical Consultant - Pharmacist will participate in and help lead projects with GHSC’s clients. Our clients are primarily agencies responsible for State Medicaid and CHIP fee-for-service and managed care programs.
• The person in this role is part of a multi-disciplinary GHSC team working to ensure that financial, policy and clinical considerations are addressed for our clients.
• Some of the responsibilities of this role include providing our clients with Medicaid and CHIP managed care and fee-for-service pharmacy benefit policy and operational expertise, project management, team management, client management, analytical oversight and business development. 

We will count on you to:

• Participate as a team member and help lead projects to help states develop, implement, and improve their managed care Medicaid and CHIP pharmacy programs

• Participate in FFS reimbursement rate support by providing expertise in pharmacy reimbursement methodologies, including review of rate calculations and knowledge of reimbursement metrics (e.g. NADAC, AAC, WAC, MAC, COD surveys, trend analysis)

• Be viewed by the client as an expert on Medicaid pharmacy program design in areas that may include policy, federal authorities, program operations, financial and budgeting aspects of Medicaid and CHIP programs 
• Clearly define the scope, timelines, staffing and deliverables for the project and ensure the project team is within budget, on time and providing deliverables consistent with the scope 
• Consider the implication of policy, legal, political or other changes on the operation of a state’s Medicaid pharmacy program 
• Present results and analysis to clients and key stakeholders; during presentations, answer detailed and challenging technical questions regarding the data and analytical methodology  
• Work on multiple projects with multiple clients simultaneously 
• Assist in responding to RFPs including developing strategy, writing the technical proposal, and developing the budget/cost proposal 

What qualifications are necessary to have for the role?

• RPh or PharmD
• Active pharmacy license in at least one US state
• Minimum of 10 years of relevant Medicaid-focused pharmacy experience
• Track record of leading effective project teams and being accountable for project results 
• Ability to thrive in a work environment where teammates and clients are distributed across the country (i.e., video conference meetings are common)

What makes you stand out:

• Subject matter expertise in pharmacy-related value-based purchasing, alternative payment methodology, Medicaid managed care rate development support, 340B drug pricing, and/or Medicaid PBM procurement including CMS certification
• Experience identifying, designing, recommending, and implementing efficient, innovative business solutions to client’s complex challenges 
• Leadership role in a State Medicaid agency (e.g., Pharmacy Director) including experience with regulations, waivers, state plan amendments and/or state operations related to pharmacy services
• Leadership role in a Medicaid Managed Care Organization (e.g., Pharmacy Director), including regular interaction with the Medicaid Agency Pharmacy Director
• Relentless curiosity and a desire for continuous learning
• Deep desire and experience solving complex problems

Why join our team:

• We help you be your best through professional development opportunities, interesting work and supportive leaders
• We foster a vibrant and inclusive culture where you can work with talented colleagues to create new solutions and have impact for colleagues, clients and communities
• Our scale enables us to provide a range of career opportunities, as well as benefits and rewards to enhance your well-being

Mercer, a business of Marsh McLennan (NYSE: MMC), is a global leader in helping clients realize their investment objectives, shape the future of work and enhance health and retirement outcomes for their people. Marsh McLennan is a global leader in risk, strategy and people, advising clients in 130 countries across four businesses: Marsh, Guy Carpenter, Mercer and Oliver Wyman. With annual revenue of $24 billion and more than 90,000 colleagues, Marsh McLennan helps build the confidence to thrive through the power of perspective. For more information, visit mercer.com, or follow on