Details
03/28/2025
Pharmacy Clinical Administrator
Ohio Department of Medicaid
The Ohio Department of Medicaid (ODM) is recruiting for a Pharmacy Clinical Administrator with significant pharmacy experience. As the Pharmacy Clinical Administrator, your duties will include: Overseeing the development of the Preferred Drug List (PDL) approval criteria for prior authorization requests with regard to medical appropriateness, dosage, route of administration and duration Managing the development, coordination and implementation of Medicaid coverage and reimbursement policies for pharmaceutical services based upon broad federal guidelines, state regulations, Medicaid Drug Rebate Program, litigation, administrative decisions and analysis of legislation Implementing proposed policies through rule promulgation process Ensuring compliance with state and federal laws and guidance regarding Single Pharmacy Benefit Manager (SPBM), Pharmacy Pricing and Audit Consultant (PPAC), pharmacy claims processing and payment Representing the Director on behalf of the agency Supervising assigned staff Making recommendations for hire Assigning work and providing direction Reviewing work and providing feedback Establishing goals, monitoring, and evaluating performance.
