Manager - Policy / Program

Description & Requirements

Maximus is currently hiring for a Manager - Policy / Program to join our State East team.

The Manager will support New Jersey State Arbitration.

They are responsible for overseeing arbitration proceedings to resolve any dispute raised by carrier or pharmacy.

This includes but is not limited to client communication, quality control, and case processing.

Essential Duties and Responsibilities:

- Provide legal research, guidance, advice, leadership, and training to project staff, ensuring compliance with all project and client policies/procedures, laws, and regulations.

- Interact with the client regarding case decisions.

- Guide teams to ensure all major client/legal requirements are met and relevant documents are captured accurately.

- Provide self-directed legal support to the project leadership.

- Process and resolve high profile and complex cases.

- Manage direct reports, including hiring, setting monthly individual/team goals, and evaluating employee performance.

Minimum Requirements

- Juris Doctorate from an accredited law school required.

- 3-5 years of related professional experience.

- Experience with pharmacy claims/reimbursements required.

- Experience using health care pricing benchmark data or other pharmacy pricing databases required.

- Experience with pharmacy/PBM appeals and maximum allowable cost strongly preferred.

- Experience in prescription drug pricing dispute resolution and/or arbitration on behalf of State or federal government agencies strongly preferred.

- Licensed pharmacist preferred.

Please note: For this position Maximus will provide equipment to use.

Home Office Requirements:

- Internet speed of 20mbps or higher required / 50 Mpbs for shared internet connectivity (you can test this by going to www.speedtest.net)

- Minimum 5mpbs upload speed

- Connectivity to the internet via either Wi-Fi or Category 5 or 6 ethernet patch cable to the home router

- Private work area and adequate power source

- Must currently and permanently reside in the Continental US

EEO Statement

Active military service members, their spouses, and veteran candidates often embody the core competencies Maximus deems essential, and bring a resiliency and dependability that greatly enhances our workforce.

We recognize your unique skills and experiences, and want to provide you with a career path that allows you to continue making a difference for our country.

We're proud of our connections to organizations dedicated to serving veterans and their families.

If you are transitioning from military to civilian life, have prior service, are a retired veteran or a member of the National Guard or Reserves, or a spouse of an active military service member, we have challenging and rewarding career opportunities available for you.

A committed and diverse workforce is our most important resource.

Maximus is an Affirmative Action/Equal Opportunity Employer.

Maximus provides equal employment opportunities to all q...