Requisition No: 877697

Agency: Agency for Health Care Administration



Pay Plan: Career Service

Position Number: 68061946

Salary: $4,107.39 Biweekly

Posting Closing Date: 06/25/2026

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Position Overview:

This is an exciting opportunity to help shape the quality of health care in Florida.

We are seeking to hire a Senior Pharmacist who desires to work to enhance the delivery of health care services through the Florida Medicaid Program.

This position requires a candidate who is creative, flexible, innovative, and who will thrive in a fast-paced, team based work environment.

This position is located in the Bureau of Medicaid Quality. Medicaid Quality provides data-driven, focused and systematic feedback on the quality of Florida's Medicaid program to federal and state agencies, Medicaid recipients, Medicaid managed care plans, and providers.

The Bureau of Medicaid Quality has a strong focus on providing more comprehensive care, improving health outcomes, and reducing costs.

This position is responsible for maintaining knowledge of statutes and rules concerning the work-related programs/initiatives, including: Florida Statutes, Florida Administrative Code, U.S. Code of Federal Regulations, contract guidelines, provider handbooks, federal laws and regulations; maintaining knowledge of Medicare and other healthcare programs (furnishing expert pharmaceutical experience), and their impact on Medicaid coverage and eligibility.

Coordinating projects and quality-related programs; determining the fiscal and clinical impact of changes or proposed changes in practices and health service delivery; producing analytical/statistical reports; coordinating research and evaluations of initiatives; composing and reviewing interoffice and external communications; coordinating the design and development of special reports prepared from data maintained by subcontractors and the Agency.

Researching databases for evidence-based literature (outcome studies) to support policy recommendations.

Identify and document the need for special studies and projects to provide information and data for policy and program development activities.

Review and analyze state and federal audit reports, program evaluations, monitoring reports, provider and recipient correspondence and other materials to determine the need for new or improved programs or major policy revisions.

Identify, develop and implement more effective methods for involving providers, recipients and other departmental staff in policy and procedure revisions for Medicaid Fee-for-service and Managed Care programs.

Review major policy proposals with other department staff, the Drug Utilization Review Board, the Pharmacy and Therapeutic Committee, provider groups and associations as needed.

Maintain knowledge of organizational, operational, and programmatic concepts and practices applied by public, private and nonprofit agencies and organizations engaged in pharmacy services activities.

Maintain pharmaceutical knowledge of evidence-based treatments for medical and mental health conditions.

Maintain and apply professional expertise to the evaluation of medication best practice guidelines to improve health outcomes in the Medicaid population.

Stay current with the scientific literature and provide clinical consultation to Agency staff as requested.

Serve as the subject matter expert for reporting to Federal Agencies.

Responsible for designing and maintaining clinical and operational oversight frameworks that evaluate pharmacy benefits compliance with state contractual requirements, preferred drug lists (PDLs), prior authorization (PA) criteria, utilization management standards, and applicable Medicaid policy.

Utilizes encounter data, pharmacy claims data, MCO contracts, and MCO policies and procedures to identify trends, outliers, inappropriate utilization patterns and areas of financial or clinical risk requiring corrective action or escalation.

This is an anticipated vacancy.

This position will be hired at the non-negotiable rate of $4,107.39/bi-weekly.

This position is not a remote or telework position.

Benefits of working for the State of Florida:

Working for the State of Florida is more than a paycheck. We offer an excellent array of benefits, including:
• Health insurance (i.e., individual and family coverage) to eligible employees
• Life insurance; $25,000 policy is free plus option to purchase additional life insurance
• Dental, vision and supplemental insurance
• State of Florida retirement options, including employer contributions
• Ability to earn up to 104 hours of paid annual leave as a new employee with the State of Florida
• Ability to earn up to 104 hours of sick leave annually
• Nine paid holidays and 1 personal holiday each year
• Opportunities for career advancement
• Tuition waivers (accepted by major Florida Colleges/universities)
• Student loan forgiveness opportunities (eligibility required)
• Training opportunities
• Flexible Spending Accounts
• Shared Savings Program for select medical services
• Lower copays for prescription drugs
• Health and Wellness discounts

For a more complete list of benefits, please visit https://www.mybenefits.myflorida.com/

For more information about the Bureau of Medicaid Quality, please visit our website at http://ahca.myflorida.com/Medicaid/index.shtml.

KNOWLEDGE, SKILLS, AND ABILITIES

Possess problem solving skills and the ability to participate effectively in decision making processes.

Possess excellent telephone communication skills, including the ability to effectively translate complex information into common language and communicate professionally with other healthcare professionals.

Maintain knowledge of Medicaid program policy and provider billing procedures.

Demonstrate computer knowledge and proficiency using Microsoft Office programs.

Ability to travel with or without accommodation.

MINIMUM QUALIFICATIONS REQUIREMENTS

One year of professional experience in the practice of pharmacy.

Licensed as a Registered Pharmacist in accordance with Florida Statute 465.

LICENSURE, CERTIFICATION, OR REGISTRATION REQUIREMENTS

Licensure as a Pharmacist in accordance with Florida Statute 465.

CONTACT: BETTHANY GARDNER 850-412-4260

Location: