Pharmacy Benefit Manager (PBM) Analyst (Operations & Policy Analyst 3)

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Job Description:

The Oregon Division of Financial Regulation is developing a new compliance unit focused on Pharmacy Benefit Managers (PBMs). In recent years, PBMs have been the focus of legislative action and regulatory scrutiny across the nation. This position will help to design, build, and guide the Oregon PBM compliance standards and procedures. This position will work closely with the PBM Compliance Manager, internal subject matter experts, and experts at other state regulatory agencies to develop this program.

Our mission...

To protect and serve Oregon's consumers and workers while supporting a positive business climate.

The Department of Consumer and Business Services (DCBS) is a progressive business regulatory state agency dedicated to the mission of protecting and serving Oregon's consumers and workers while supporting a positive business climate. The department administers state laws and rules governing workers' compensation, occupational safety and health, financial institutions, insurance companies and building codes. The department has consumer protection and education programs, offices, and ombuds to help consumers, injured workers, and businesses.

This position is with the Division of Financial Regulation (DFR). DFR’s mission supports that of the department by protecting Oregonians’ access to fair products and services through education, regulation, and consumer assistance. The division is responsible for ensuring the safety and soundness of financial institutions, the availability and affordability of financial products, and the fair treatment of consumers. Functions include licensing, regulating, and monitoring the conduct of banks, credit unions, financial services providers, health care service contractors, insurance companies, and licensed or registered agents of such entities.

This position is represented by the Service Employees International Union (SEIU).

Recruitment Timeline:

*These dates are approximate and are subject to change.*

Recruitment closes: October 30, 2024

1st round interviews: first week of November

2nd round interviews: first week of December

Anticipated start date: first week of January 2025

What’s in it for you:

• Rewarding work in a productive and creative environment

• Colleagues who are passionate about public service

• Work/life balance, 11 paid holidays a year, and a competitive benefits package

• Advancement and learning opportunities that will help grow your career with the State of Oregon

• Possible eligibility for the Public Service Loan Forgiveness Program

This position is eligible for fully remote work once the incumbent has gained the proficiency to perform work independently. The incumbent may occasionally be asked to work from the office on an as-needed basis.

Here’s what you will do:

As the PBM Analyst, you will serve as the PBM Compliance team’s lead analyst, project manager, and subject matter expert on the pharmacy benefit manager industry and market. Duties include:

• Developing market surveillance techniques, complaint intake procedures, complaint investigation procedures, and case management processes

• Investigating complaints against pharmacy benefit managers

• Reviewing business practices for compliance with ORS 735.534 and other applicable statutes

• Working with regulated entities on remediation plans

• Conducting stakeholder outreach and education

• Documenting cases for referral to the enforcement team

• Consulting with the enforcement team on appropriate sanctions for regulated entities

For a complete listing of the duties and responsibilities of this position, please review the position description by clicking here.

Here’s what you need to qualify:

Minimum Qualifications:

• A bachelor's degree in Business or Public Administration, Behavioral or Social Sciences, Finance, Political Science or a related degree; and four years professional-level evaluative, analytical and planning work

OR

• Any combination of experience and education equivalent to seven years professional-level evaluative, analytical and planning work

Requested Skills:

• While not required, the following skills and experience will be valuable in this role:

• Exceptional ability to design, evaluate, and modify a new compliance program

• Expert proficiency in public relations and good oral and written communication skills

• Proficient project management fundamentals and strong organizational skills to address conflicting priorities and meet imposed deadlines

• Strong interpersonal skills

• Expert experience facilitating meetings and committees, particularly when working with people with diverse interests

• Expert experience in policy development and understanding how to communicate impacts of policy changes on project timelines and initiatives

• Expert knowledge of any of the following concepts: health policy, health insurance regulation, health insurance plan design, pharmacy procedures

Application information:

• A resume and cover letter are required for this job posting. Please attach them in the “Resume / Cover Letter” section of the application.

• Please ensure that you clearly demonstrate in your application materials that you meet the qualifications listed and that you follow all instructions carefully. Only complete applications received by the posted application deadline date will be considered.

• You may be asked to submit a skills assessment, a writing sample, or a video interview as part of the application screening process.

Additional information:

• Per the Pay Equity Law passed in 2017, a pay equity analysis will be conducted to determine what pay step the successful candidate will be offered.  The analysis will be based on the relevant experience, education, training, and certifications documented in the application materials.  On average, candidates new to state service will most likely be offered compensation in the lower to mid-level of the salary range.

• The successful candidate must have a valid driver's license and a satisfactory driving record. Before an offer of employment, DCBS may request that you provide an official driving record.

• This position is subject to a fingerprint background check for any convictions directly related to its duties and responsibilities. Only job-related convictions will be considered and will not automatically disqualify the candidate.

• Eligible veterans who meet the qualifications will be given veterans' preference. For further information, please see the following website: Veterans Resources. NOTE: If claiming veterans’ preference please be sure to check your Workday account for pending tasks or actions under your “My Applications” section.

• We hire preferred workers!  For more information, please visit our website: Preferred Worker Program.

• The Department of Consumer and Business Services (DCBS) does not offer VISA sponsorships. If your employment authorization and documentation is contingent on sponsorship now or in the future, you will not meet our agency employment eligibility standards. Within three days of hire, you will be required to complete the US Department of Homeland Security's I-9 form confirming authorization to work in the United States. DCBS will use E-Verify to confirm that you are authorized to work in the United States.

Helpful links and contact information:

Learn more about DCBS

Understanding the State Application Process

Help and Support webpage

For more information you may contact us by e-mail at DCBS.Recruiting@dcbs.oregon.gov or by phone at 503-378-3200.

DCBS is fully committed to attracting, retaining, developing, and promoting the most qualified candidates without regard to their race, gender, color, religion, sexual orientation, national origin, age, physical or mental disability, or veteran status.  For more information, please visit our diversity, equity and inclusion webpage.