The Pharmacy Benefits Division is recruiting to fill one Pharmaceutical Program Consultant, Chief, Pharmacy Data Branch position.
Salary listed does include the $2,000/month Retention & Recruitment (R&R) pay.
****DUTIES**** Under the general direction of the Chief, Pharmacy Benefits Division (CEA 3), incumbent serves as the chief pharmaceutical data consultant for the Medi-Cal fee-for-service program, giving professional advice and guidance to the Department of Health Care Services (DHCS) executive staff, and other agencies, on matters relating to the scope and quality of pharmaceutical and medical supply benefits under Medi-Cal; develops fiscal analyses based on historical and projected claims utilization and costs; researches, analyzes, and develops budget-related data and provides recommendations to upper management and California’s Health and Human Services Agency; researches and analyzes claims trends and prescribing patterns for purposes of deciphering possible issues of misuse, fraud, or abuse; participates in academic detailing of Medi-Cal prescribing entities for purposes of improving prescribing practices; works collaboratively with staff in other divisions to improve the databases within the department used for purposes of tracking and evaluating claims data; supervises the Pharmaceutical Data Branch.
The Pharmacy Data Branch is tasked with the following:
• Data Analysis: Systematically generate, review, analyze, and report on drug use and provider prescribing data in Medi-Cal, with the aim of improving patient care, reducing fraud and abuse, and controlling costs. Answer internal and some external queries regarding drug and medical supply use.
• Fiscal Analysis: Using retrospective and prospective data generate fiscal reports and assumptions for purposes of evaluating the productivity and effectiveness of manufacturer contracting, utilization controls, program policies, and state and federal codes and statutes related to the development of the Medi-Cal pharmacy benefit.
• Budget analysis and recommendation: Research, evaluate, and develop budget related analyses and reports used to propose cost-saving mechanisms, recommend refinements of the pharmacy benefit, and analyze effects of changes to the benefit.
• Drug Utilization Review (DUR) and Academic Detailing: Use claims and rebate data to evaluate issues related to drug utilization. Using the results of the DUR data to inform and educate pharmacy providers regarding appropriate utilization and dispensing of medications used in Medi-Cal.
• Step Therapy System: Work with the California Medicaid Management Information Systems (CA-MMIS) Division in designing a flexible, table-driven system that can be applied to permit or deny payment for many different drugs or classes of drugs. Establish other step-care protocol edits for many classes of drugs or disease states, based on the system designed in a system development notice (SDN) or without a SDN.
Work collaboratively with the Pharmacy Policy Branch to design step-care protocols that follow a logical progression in the treatment of disease where appropriate, less dangerous or expensive therapy is tried or considered before inappropriate, or more dangerous or expensive therapy is used.
The purpose of step-care protocols is to improve patient care and save program dollars by creating a mechanism where more careful control of dangerous or expensive drugs can be achieved while not requiring all such claims be prior authorized. This involves coordination with the DUR Board, bringing medical experts together with consumer and provider groups to establish logical and legally defensible rules the Step Therapy System and provider outreach programs will follow. Coordinate outreach through direct face-to-face visits with selected prescribers and pharmacies, educational program meetings, mailed printed materials, and contractually-arranged visits by manufacturer representatives, to coordinate and implement Medi-Cal’s medication excellence education programs.
**** DIRECTIONS**** If interested, please submit a State Application (Std. 678) and résumé to the address below. On your application, please state the position you are applying for and the position number (805-560-7964-001). Also, in the “Explanation” Section (old Box 12) of your application, please state the basis of your eligibility to this classification. Please email the contact for a copy of the Statement of Qualifications Questionnaire.
If you are not a current State employee, you must have reinstatement eligibility to this level or complete an examination with the State of California and be reachable on a list in order to be appointed. Applications will be screened and only the most qualified applicants will be interviewed. ALL APPLICATIONS MUST BE IN OUR OFFICE BY 5:00PM ON APRIL 22, 2013.
|Pharmaceutical Program Consultant
||805 - 560 - 7964 - 001
|Final Filing Date:
|Pharmacy Benefits Division, MS 4604
P. O. Box 997413
Sacramento, CA 95899
Current CA RPh License