Career Center

Position 1: Clinical Pharmacist - Government Programs/Medicaid Specialist

The Clinical Pharmacist – Government Programs/Medicaid Specialist works in conjunction with key internal and external stakeholders to support the clinical pharmacy-related components of our Government Programs with specific focus on Medicaid. Key areas of focus include formulary maintenance and communication, utilization management, clinical programs, drug utilization review, and quality initiatives. The individual in this role will insure that formulary-related work and drug utilization review (DUR) programs aligns with state and federal requirements. This person has a strong understanding of the unique needs of the Medicaid membership, and effectively partners with key stakeholders to tailor and coordinate clinical programs to address each Medicaid program’s needs. This individual also has strong presentation skills and a strong understanding of state specific Medicaid requirements, the health plan space, PBM business practices, and vendor management. The incumbent will need to effectively navigate a large health care organization and understand the unique needs of customers including members, providers, and internal peers. This position will interact regularly with the PBM, the medical pharmacy and MTM vendors, the Pharmacy Services team, the Medicaid product, Medica’s Care Partnership and Behavioral Health teams, and the Regulatory and Compliance teams. 

Qualifications: 

• Bachelor's degree in Pharmacy or PharmD
• 7 years of work experience
• Valid registered pharmacist license (in any state)

Skills and Abilities:

• Prior experience with regulated markets from a health plan or PBM standpoint is required
• Previous health plan experience preferred
• Operates with flexibility in changing business environment
• Proven track record on consistently achieving desired results
• Organized individual who can simultaneously balance and- execute through multiple projects and priorities
• Self-starter, possessing willingness and ambition to work through ambiguity
• Creative thinker Motivated to problem solve
• Ability to present to an executive audience
• Collaborative, team-oriented spirit
• Excellent written and verbal communication skills
• Customer/patient focused

This position is a Hub role, which requires an employee to occasionally come onsite to the designated office, Minnetonka, for applicable heads-up work. Frequency is determined by business need as decided by leadership.

Position 2: High Cost Claimant Pharmacy Program Manager IV

The High Cost Claimant Pharmacy Program Manager works in conjunction with key internal and external stakeholders in the identification and management of high impact claimants across all Medica markets and lines of business.  The incumbent will have a robust understanding of enterprise pharmacy programs across both the pharmacy and medical benefit, and a keen sense for actionable situations.  The individual in this role will be responsible for providing regular communication and reporting to key stakeholders.  Additional job responsibilities include tracking high impact pipeline products and delivering written and verbal presentations both internally and to Medica’s clients.

Qualifications: 

• Bachelors degree in Pharmacy or PharmD or equivalent experience in related field, plus 7 years of work experience beyond degree 
• Active MN Pharmacist license required

 Skills and Abilities:

• Experience leading cross functional projects is required
• Prior experience with specialty pharmaceuticals is preferred
• Prior experience with clinical pharmacy assessments and care coordination preferred
• Previous health plan experience/exposure preferred
• Familiarity with pharmacy billing, reimbursement, and/or pharmaceutical manufacturer contracting is a plus
• Operates with flexibility in changing business environment
• Proven track record on consistently achieving desired results
• Organized individual who can simultaneously balance and- execute through multiple projects and priorities
• Self-starter, possessing willingness and ambition to work through ambiguity
• Creative thinker
• Motivated to problem solve
• Ability to present to an executive audience
• Collaborative, team-oriented spirit
• Excellent written and verbal communication skills
• Customer/patient focused

This position is a Hub role, which requires an employee to occasionally come onsite to the designated office Minnetonka for applicable heads-up work. Frequency is determined by business need as decided by leadership.

Medica's commitment to diversity, equity and inclusion (DEI) includes unifying our workforce through learning and development, recruitment and retention. We consistently communicate the importance of DEI, celebrate achievements, and seek out community partnerships and diverse suppliers that are representative of everyone in our community. We are developing sustainable programs and investing time, talent and resources to ensure that we are living our values. We are an Equal Opportunity/Affirmative Action employer, where all qualified candidates receive consideration for employment indiscriminate of race, religion, ethnicity, national origin, citizenship, gender, gender identity, sexual orientation, age, veteran status, disability, genetic information, or any other protected characteristic.