Hybrid Government Sector Medicaid Project Manager

An employer is looking for a highly-skilled Unified Preferred Drug List (PDL) Project Manager to join one of our largest national healthcare clients for a hybrid contract-to-hire opportunity. Int his role you'll join a growing team of 12 between the client, stakeholders and other vendors. The team is made up of Pharmacists and business resources from the client, the State and multiple supporting vendors. In this role you'll manage the implementation of a single PDL on behalf of the Georgia Department of Community Health (DCH) from the perspective of the client as the Single PDL vendor, supporting DCH’s efforts to align the PDL between the Fee-for-Service (FFS) program and the newly contracted Care Management Organizations (CMOs).The Unified PDL Project Manager reports to the Account Director and works closely with the DCH Pharmacy team, Northstar Healthcare Consulting (NHC), Prime Therapeutics, CMO vendors, and other DCH resources to execute DCH’s desired approach for aligning stakeholder notifications, Utilization Management (UM), system messaging, system editing, and pricing. You also will manage the overall unified PDL project plan including Project Schedule, Risk Management Plan, Communication Plan, Status Reporting, Project Roles, and Responsibilities. In order to be successful on this team you must have prior experience working cross functionally, and at least 5 years of experience leading Medicaid Implementations, Medicaid Pharmacy initiatives or similar projects. Prior experience specifically with the Georgia Medicaid Program is necessary in order to be successful on this team. This role is a 1 year contract to hire based on performance and success of the project.

Responsibilities:
1. Manage Unified PDL project from Kickoff through go-live
2. Identify work, dependencies, timelines, and resource assignments
3. Manage workplan for unified PDL activities
4. Align unified PDL work with major milestones during CMO implementation
5. Interface with key stakeholders at Optum, DCH, NorthStar, Prime, and CMO
6. Lead workgroups to modify current Drug Utilization Review Board process, new drug process and other related processes to include CMO representation and activities in support of unified PDL
7. Operationalize the creation and delivery of a PDL file from Optum to the CMO PBMs
8. Implement process(es) to create, deliver, archive, and maintain Initial and ongoing communications for PDL alignment areas
9. Implement process to promulgate PDL information to DCH website and/or other locations
10. Provide project status reports to Optum and DCH

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-5+ year history of leading Medicaid implementations, managing Medicaid pharmacy initiatives or similar projects.
-Familiarity with the Georgia Medicaid program, Pharmacoeconomics, and the integration points between vendors.
-High proficiency in Microsoft Office desktop applications, Microsoft Project, Microsoft Teams, plus experience in facilitating in-person and virtual meetings.
-Prior experience working for a state government sector

-Project Management Professional (PMP) Certification
-Fee for service and Managed Medicaid program experience, Project Management, Medicaid rebates, Medicaid pharmacy claims processing, pharmacy reporting and analytics, Georgia Medicaid

Benefit packages for this role will start on the 1st day of employment and include medical, dental, and vision insurance, as well as HSA, FSA, and DCFSA account options, and 401k retirement account access with employer matching. Employees in this role are also entitled to paid sick leave and/or other paid time off as provided by applicable law.