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Pharmacy Benefits, Manager

Recruitment #140509-UNCA-06


 A resume and cover letter must be submitted along with your application.

The Office of Management and Enterprise Services (OMES) is a government agency providing services to other Oklahoma government agencies. We work toward the goals of capitalizing on available resources, continuing to seek cost saving opportunities and elevating our level of service. Our mission is to be a “FAST” agency: Flatter, Agile, Streamlined, and Technology-enabled.

The Employees Group Insurance Division is seeking a full time Manager of Pharmacy Benefits for our Oklahoma City location. This is an unclassified position within Oklahoma State Government.  In addition to a generous Benefits Packet the annual salary for this position is up to $69,504.00 based on education and experience. 

Principal Responsibilities: 
•Assists in analyzing, planning, coordinating and implementing specific programs, policies or services relating to pharmacy, insurance coverage for eligible current and former state, education, and local government employees and their dependents.  Prepare recommendations for changes or improvements as needed.

•Monitors contractual obligation of the Pharmacy Benefit Manager (PBM) to see that obligations are fulfilled.  Track performance guarantees agreed to in contract.  Coordinates services of pharmacy consultant to assist with monitoring the PBM.  Responsible for implementing new utilization programs, benefit changes and ACA requirements.

•Reviews pharmacy complaints and other information received from participants; works closely with the PBM in the resolution of the complaints and claims issues received; coordinates resolution with other departments, providers or third party administrators as needed.

•Responsible for advising and informing the Administrator and Deputy Administrator of activities, outcomes, problems and projects relating to all significant activity undertaken in the performance of responsibilities and authority.  Also advises them of changes in industry, regulations and standards, etc.

•Serves on special committees as requested by the Administrator or Deputy Administrator, i.e. creation of Invitations to Bid and evaluation thereof for the programs and services offered by EGID.

•Reviews all Center for Medicare and Medicaid Services (CMS) guidance, monitors CMS bi-weekly calls and works with other departments and PBM regarding implementing all Part D changes.  Works with PBM in regards to the review and filing of the Medicare formularies which occur on a bi-annually and monthly basis.  Responsible for the review/response of CMS complaints and appeals.

•Meets bi-weekly with PBM to resolve globally identified issues.  Monitors current benefits/programs, discusses future benefits or other pharmacy program changes, etc.

Knowledge, Skills and Abilities:
•Must have excellent organizational skills and the ability to handle several high-priority projects simultaneously.
•Must have excellent written and verbal communication skills.
•Must be able to establish and maintain effective working relationship with others and work effectively in a group.
•Must have extensive knowledge in development and implementation of written policies and procedures.

Supervisory Responsibilities: Supervisor of a small unit of four staff members  

Minimum Qualifications:
A Bachelor’s Degree and four (4) years of experience with a health insurance company or related field; or an equivalent combination of education and experience.


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