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Pharmacy Benefits Market Examiner
Pharmacy Benefits Market ExaminerState of Idaho • Boise, ID, US
Pharmacy Benefits Market Examiner

Pharmacy Benefits Market Examiner

State of Idaho • Boise, ID, US
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Overview

The Idaho Department of Insurance (DOI) is seeking a Pharmacy Benefit Market Examiner. This full-time benefited position is located in downtown Boise, in the Market Oversight Bureau, and reports directly to the Bureau Chief. The role focuses on regulatory activities related to pharmacy benefit managers, including compliance. The department seeks someone with a passion for protecting Idahoans, a deep understanding of pharmacy benefits, and excellent communication skills.

How to apply : After reviewing this announcement, please attach and submit a resume relevant to this position, a list of three professional references detailing the length and nature of your association, and a cover letter describing your position-related background and experience, including any insurance, market conduct, or pharmacy benefit conduct experience.

Responsibilities

  • Conduct activities related to pharmacy benefit compliance, including overseeing the work of contractors.
  • Implement reporting requirements for Pharmacy Benefit Managers in accordance with regulation.
  • Investigate complaints related to Pharmacy Benefit Managers.
  • Identify, diagnose, and resolve areas of concern related to pharmacy benefits and pharmacy benefit managers.
  • Perform specialized analysis of pharmacy benefit managers by reviewing required reporting, complaints, and other related information.
  • Confer with and advise management regarding insurance company compliance with Idaho Code, federal regulations, informational bulletins, and attorney general opinions affecting the insurance industry.
  • Prepare written workpapers to illustrate and document work accomplished and demonstrate achievement of agency market analysis and examination objectives.
  • Work closely with staff and attorneys regarding legal matters, represent the department in administrative actions, and testify in hearings when needed.

Ideal Candidate Has

  • A broad understanding and professional experience with pharmacy benefit managers, pharmacy insurance contracts, or a related area.
  • An understanding and respect for the Idaho Insurance Code.
  • Compelling customer service and a desire to assist Idahoans.
  • The ability to clarify and explain complex issues in understandable terms.
  • Critical thinking and collaboration to solve complex problems, including proactive decision-making in a changing landscape.

    • Minimum Qualifications

  • Good knowledge of insurance, pharmacy benefits, or financial industry regulation.
  • Good knowledge of research and analysis methods and statistical techniques.
  • Experience compiling and analyzing statistical data, drawing conclusions, and presenting recommendations verbally and in writing.
  • Ability to analyze complex issues.
  • Experience interpreting and applying federal and state laws, rules, and directives.

    • Desired Qualifications

  • Two years of experience as a pharmacy benefit plan administrator or similar position; or equivalent education such as a degree in pharmacy.
  • Professional designations or licenses such as pharmacist license, pharmacy technician license (MCM, AIE, CIE, APIR, or PIR).
  • Direct regulatory experience and / or a deep understanding of the insurance industry with emphasis in pharmacy benefits and compliance with laws and regulations.
  • Spanish language proficiency is preferred but not required.

    • Supplemental Information

  • Occasional work-related travel may be required throughout the year.
  • This position is exempt from classified state service and the rules of the Division of Human Resources and the Idaho Personnel Commission.

    • Benefits

  • Excellent medical, dental, and vision insurance health plans
  • Nationally recognized PERSI retirement benefits
  • Paid sick and vacation leave accrual upon hire
  • Paid parental leave
  • 11 paid holidays annually
  • A healthy work-life balance
  • Career growth and professional development opportunities

    • EEO / ADA / VETERAN

    The State of Idaho is committed to providing equal employment opportunities and prohibits discrimination against qualified individuals based on protected status, including veterans or individuals with disabilities, and on other protected characteristics. Reasonable accommodations are available upon request. If you require an accommodation at any step in our recruitment process, please contact the Idaho Department of Labor HR ADA Coordinator at 208-334-2263 or ada.coordinator@dhr.idaho.gov.

    The mission of the Department of Insurance is to serve and protect Idahoans by equitably, effectively, and efficiently administering the Idaho Insurance Code and the International Fire Code. The DOI is located in downtown Boise across from the state Capitol Building. Boise is widely recognized as a great place to live. For more information about Idaho DOI, visit the DOI website and follow us on Facebook, X (formerly Twitter), and LinkedIn.

    Employment type

  • Other

    • Seniority level

  • Entry level

    • Job function

  • Other

    • Industries

  • Government Administration

    • J-18808-Ljbffr

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    Examiner • Boise, ID, US