Principal, Government Policy And Strategy

Min 10 yrs required

Full-time

No

Principal, Government Policy and Strategy
The candidate reviews new and pending legislation and regulatory materials relative to Medicaid, MMP and Marketplace with an emphasis on prescription drug management. Review, interpret and provide internal guidance on operationalizing proposed, adopted, and promulgated state and federal regulation for Marketplace, Medicare, Managed Medicaid and Fee for Service Medicaid. Work to ensure company programs meet State and Federal regulations. Serves as a as key liaison between GPS, and MedImpact Regulatory Compliance and Legal Departments to ensure alignment on interpretation and execution of policies as necessary. Determine requirements and gives internal direction on internal system changes to monitor for new federal and state legislation, contractual updates, and other related regulatory guidance. Evaluate and document consequences and risk in determining cost of compliance for new legislation, policy, and state or federal guidelines. Advise Government Programs, Compliance and Legal regarding contractual requirements on Managed Care and Government Programs, including Policy & Procedure documentation, and operational process adjustments that are deemed necessary for each program to be compliant with the client contract and reviewed regulatory requirements. Resource for Request for Proposal (RFP) response interpretation and development. Research regulation in states where MedImpact is a new vendor. Interfaces cross functionally to consult in support of key initiatives. Bachelor’s Degree required; advanced degree preferred. Ten (10) years of experience in Managed Care and Government Programs is required; or equivalent combination of education and experience. Proficient in Microsoft Office Suite products, including Access, Visio, Excel, Word, and others. Juris Doctorate degree or Paralegal certificate preferred. Prior senior professional level experience in Managed Care or Government Programs. Requires broad experience with overall PBM functions across all applicable business lines including commercial, healthcare reform, Medicare, and Medicaid. Requires prior experience with Medicare Part D, Managed Medicaid, Marketplace Exchange and CMS CDAG and formulary processes. Strong communication skills both written and verbal.

Legal