Pharmacy Policy Section Manager

The Department of Health Services (DHS) , Division of Medicaid Services (DMS) is recruiting to fill the Pharmacy Policy Section Manager, within the Bureau of Clinical Policy and Pharmacy (BCPP). BCPP develops and oversees Medicaid clinical policies, prior authorization operations, and pharmacy benefits to ensure members receive the right services at the right time.

This position has the ability to work remotely up to 5 days per week but may be required to report to an office location on occasion to complete certain tasks. This position will be headquartered at one of our central or regional offices . This schedule may vary based on training or operational need.

As an employee of the State of Wisconsin, you'll also have access to an amazing benefits package , including:

• 3.5 weeks of vacation, 9 paid holidays and ample sick time; limitations may apply for leave time usage in the first six months.
• Top rated health plan options starting at $47/month for single plans and $117/month for family plans, after 2 months of state service.
• Exceptional pension plan with a 7.25% employer match in 2027 with lifetime retirement payment. Plus, a tax advantaged supplemental retirement savings plan which allows you to save money directly from your paycheck for retirement. Use this Total Rewards Calculator to see the total value of our competitive benefits package!
• Several flex spending accounts: medical, dependent care, commuter, parking and High Deductible Health Savings.
• Well Wisconsin Wellness Program.
• A free and confidential employee assistance program that offers employees and their immediate family dependents a variety of tools, resources, and professional consultation services to support their health, goals, and overall well-being.
• Public Service Loan Forgiveness Program employer.

You will be responsible for overseeing and managing pharmacy policy to ensure safe, effective, and cost-conscious medication use of Medicaid Members. Duties will include:

• Collaborating with Medicaid clinical leadership, pharmacy system and rebate team, bureau leadership, and external partners to align policies with state and federal regulatory requirements, clinical best practice, and organizational goals. You will also collaborate with both internal and external partners to support enhanced program outcomes.
• Overall management of the prescription drug policy for members in the Medicaid and Senior Care programs.
• providing leadership and direction to staff in the development of drug coverage and reimbursement policies for both outpatient and provider administered drugs to ensure member access while managing cost growth and budget impact.
• Leading the administration of Senior Care waiver benefits and federally mandated compliance efforts related to administration of the waiver.
• Supporting the Wisconsin Chronic Disease Program (WCDP) drug formulary.

Additionally, you will be responsible for ongoing development, communication of, and advocating a vision of the team and articulating the vision into a strategy to the section, bureau, other bureaus, work groups, administrator's office, and pharmacy partners.

The starting pay is between $48.00 and $52.45 per hour (approximately between $99,800 and $109,100 per year), depending on qualifications, plus excellent benefits. A 24-month Career Executive trial period is required.

Pay for current or former state employees will be set based on the rules that apply to compensation for the applicable transaction. The position is classified as a Health Care Program Manager and is in pay schedule and range 81/02.

• All applicants who may be appointed will be required to allow DHS to conduct a background check to determine whether the circumstances of any conviction may be related to the job being filled.
• For positions that allow remote working flexibility, working outside of Wisconsin or in bordering cities will not be allowed except in extremely limited circumstances due to the need to report to an office location in Wisconsin on short notice.
• Employees must have access to secure high-speed internet for remote work option. Mileage reimbursement to the employee's headquarter location is not provided. Remote work flexibility will be discussed in more detail during the interview process.
• DHS does not sponsor work visas for this position, thus, in compliance with federal law, selected candidates will be required to verify eligibility to work in the United States by completing the required I-9…