Pharmacy Department Staffing FY25-26: State Medical Professionals--25%

SCOPE OF SERVICES UKRF shall provide the programs/services outlined below. A. Provide one (1) qualified Principal Investigator (PI), the equivalent of up to 0.01 FTE, to provide oversight to the contract, provide subject matter expertise to policy development, and review findings B. Identify and provide one (1) qualified pharmacist, the equivalent of up to 1.0 FTE, to serve as Pharmacy Director providing the following services: 1. Provide oversight of the Pharmacy Medicaid program. 2. Develop and establish policies and procedures for pharmacy programs. 3. Serve as a senior advisor for the Medicaid Commissioner. a. Provide policy guidance as it pertains to issues surrounding pharmacy within the Department. b. Serve as pharmacist consultant within Cabinet regarding pharmacy practices nationally as well as within Kentucky. 4. Coordinate day-to-day Pharmacy Program activities. a. Develop, implement and evaluate program projects. 5. Contract, reimbursement and quality control systems monitoring. 6. Serve as liaison between Pharmacy Program and Managed Care Organizations. 7. Perform other duties as designated by the branch manager, division director or Medicaid Commissioner. C. Identify and provide one (1) qualified pharmacist, the equivalent of 1.0 FTE, to serve as the MCO PBM Clinical Manager. Duties include, but are not limited to: 1. Interpret pharmacy data and develop programs to optimize therapy and minimize drug costs 2. Provide clinical guidance and strategic planning support to the Pharmacy Director 3. Oversee single managed care organization (MCO) pharmacy benefits manager (PBM) activities and assist in ensuring contract compliance 4. Create, initiate and implement innovative programs and solutions to enhance healthcare outcomes for Kentucky Medicaid beneficiaries 5. Analyze, interpret and manage large data sets to assist in health policy decision making 6. Supervise, oversee and initiate projects for APPE students 7. Engage in all MCO PBM meetings by providing input and expertise where needed 8. Other duties as assigned. D. Identify and provide one (1) qualified pharmacist, the equivalent of 1.0 FTE, to serve as the Clinical Manager of Fee-For-Service (FFS). Duties include, but are not limited to: 1. Update, maintain and manage the FFS physician administered drug (PAD) list 2. Participate, engage and guide clinical decisions during quarterly P&T meetings on behalf of the Commonwealth of KY 3. Oversee the development of the Preferred Drug List (PDL) approval criteria for prior authorization requests with regard to clinical appropriateness, dosage, route of administration, duration etc. 4. Interpret drug cost data while assisting FFS PBM with all rebate operations 5. Provide oversight of Pharmacy team (Business Analysts and Medicaid Specialist) in executing day-to-day tasks 6. Interpret pharmacy data and develop programs to optimize therapy and minimize drug costs 7. Develop and implement various clinical programs in the Fee-For-Service space 8. Manage multiple projects simultaneously while meeting key deadlines and deliverables. 9. Provide clinical guidance and strategic planning support to the Pharmacy Director 10. Supervise, oversee and initiate projects for APPE students 11. Other duties as assigned