Vendor Drug Program Contract Specialist (CS IV)

TX-HHSC-DSHS-DFPSAustin, TX
10d

About The Position

The Vendor Drug Program Contract Specialist (Contract Specialist IV) is a senior-level position within the Pharmacy Rebates and Business Analysis (PRBA) unit of the Vendor Drug Program (VDP) under Medicaid/CHIP Services (MCS) at Texas Health and Human Services. This role is responsible for managing pharmacy enrollment contracts and serves as a subject matter expert for pharmacy provider enrollment. The position works closely with prospective pharmacy providers to support the enrollment process, including responding to inquiries, providing guidance on application submissions, requesting additional information, and ensuring compliance with program requirements. The Contract Specialist IV collaborates with internal program areas and external stakeholders regarding enrollment activities and serves as the primary pharmacy enrollment liaison across program areas. In addition, this position performs contract monitoring of the pharmacy system vendor to support PRBA team deliverables. Responsibilities include ensuring vendor deliverables are submitted timely, coordinating internal review of deliverables, meeting established deadlines, and communicating findings to the Vendor Drug Program contract oversight team. The position works under minimal supervision and exercises considerable initiative and independent judgment.

Requirements

  • Knowledge of State and federal laws and regulations relevant to the Medicaid/CHIP programs.
  • Contracting regulations, negotiating contracts, developing contracts, monitoring contracts. Knowledge of contract processes.
  • Skill in Operating personal computers and in using applicable software, including Microsoft products, i.e. Word, Excel, PowerPoint.
  • Organizing work, managing time, and coordinating multiple priorities, deadlines, and complex tasks.
  • Ability to Evaluate contracts and provide guidance for provider compliance; and interpret policies, procedures, and regulations in terms of pharmacy provider enrollment.
  • Interpret policies, procedures, and regulations.
  • Manage pharmacy enrollment application processing from initiation to execution.
  • Build and maintain collaborative working relationships across various divisions and teams.
  • Lead or facilitate workgroups.
  • Provide clear guidance for adequate submissions.
  • Communicate effectively both orally and in writing with internal and external stakeholders.
  • Prepare polished and well-developed communication and presentation materials.
  • Graduation from an accredited four-year college or university with major coursework in business administration or a related field is generally preferred. Experience and education may be substituted for one another on a year-for-year basis.
  • Two years of experience with contract management or contract monitoring work/responsibilities. Experience may include reviewing, evaluating, and executing new or contract renewals, or monitoring contract compliance for deliverables.
  • Certification as a Certified Texas Contract Manager (CTCM) or Certified Texas Contract Developer (CTCM), or the ability to obtain either of these certifications within one year of start date.

Nice To Haves

  • Professional work experience with provider enrollment processes.

Responsibilities

  • Contract Processing and Execution/ Management: Responsible for leading activities related to pharmacy enrollment for new contracts, contract renewals, extensions, and amendments. Reports on and provides trends regarding provider enrollment discrepancies, application volumes, vendor holds, vendor incompliance associated with contract compliance, federal/state policies, rules, and regulations. Reviews pharmacy enrollment processes and procedures to recommend improvements for better effective and efficient operations.
  • Contract Oversight: Monitors contract performance by examining contract deliverables for compliance with terms of contract and policies. Ensure deliverables from the vendor are submitted on time, the PRBA team reviews the deliverable and meets deadlines, and reports the findings back to the VDP contract oversight team. Coordinates the risk assessment process for contract monitoring and planning. Assists with developing contract administration policies and procedures.
  • Communication: Provides consultation and technical assistance to program areas regarding pharmacy enrollment needs and processes. Leads first level contract resolution efforts regarding non-compliance issues and contractor concerns with potential or approved providers. Communicates with contractors/providers verbally and in writing regarding contract executions, renewals, and remedies associated with non-compliance. Leads or facilitates internal and external workgroups. Provide guidance and act as a subject matter expert in providing input to other areas regarding pharmacy enrollment.
  • Audits: Resolves audit exceptions by defining causes of errors and recommending appropriate dispositions.
  • Training: Conducts training related to pharmacy enrollment processes and procedures, and on contract deliverable monitoring. Provides technical assistance related to pharmacy enrollment processes.
  • Other Duties: Performs other duties and related work as assigned.

Benefits

  • Our comprehensive benefits package includes 100% paid employee health insurance for full-time eligible employees, a defined benefit pension plan, generous time off benefits, numerous opportunities for career advancement and more.
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