Benefit Program Senior Specialist 3.20.25

The MO HealthNet Division has an opening for a Benefit Program Senior Specialist within the Pharmacy Administration Unit located in Cole County.

Semi-monthly salary: $2,020.69

Job Location: This position is located at the Howerton State Office Building; 615 Howerton Court, Jefferson City, MO.

The Department of Social Services partners with families and communities to protect children, rehabilitate youth and move families to self-sufficiency so that Missourians can lead safe, healthy and productive lives.

Why you’ll love this position: You will join a supportive team that values collaboration and fosters a positive workplace culture. In this position, you will enhance your customer service skills and gain knowledge of MO HealthNet policy. Daily challenges will boost your confidence, critical thinking, and creative problem-solving skills, leading to personal and professional growth. While the work can be demanding, you'll find substantial rewards in supporting Missouri's most vulnerable populations and striving for fiscal sustainability. If you're passionate about making a meaningful difference, we encourage you to apply!

What you’ll do: As an essential member of our team, you will engage in key technical work that is essential for the smooth operation of the Pharmacy Program within the MO HealthNet Division. Some of your responsibilities will include:

• Providing professional support by responding to inquiries from providers and participants via phone and email. You'll guide them through claims processes and clarify pharmacy program policies and procedures.
• Evaluating prior authorization requests for diabetic supplies and over-the-counter medications to ensure these essential resources are accessible to those in need.
• Identifying and resolving issues related to backdated prior authorizations and claims payments.
• Assessing hospice authorization requests to ensure that medications are reimbursed appropriately.

• Evaluating the eligibility of dual-eligible participants and determining the need for Medicare overrides.

Minimum Qualifications:

Bachelor’s degree and 1-3 years of relevant experience. (Substitutions may be allowed.)

Preferred Qualifications:

To be successful, the candidate must possess strong communication skills, both written and oral. Attendance and dependability are a must for this candidate, as this position is responsible for providing real-time claims adjudication assistance to providers and participants. This individual needs to have strong interpersonal skills and the ability to convey complicated information in an easy manner. This individual should have experience working independently and in a team environment. The candidate must be knowledgeable in the area of pharmacy and/or pharmaceutical products.

Lack of post-secondary education will not be used as the sole basis denying consideration to any applicant.

The State of Missouri offers an excellent benefits package that includes a defined pension plan, generous amounts of leave and holiday time, and eligibility for health insurance coverage. Your total compensation is more than the dollars you receive in your paycheck. To help demonstrate the value of working for the State of Missouri, we have created an interactive Total Compensation Calculator. This tool provides a comprehensive view of benefits and more that are offered to prospective employees. The Total Compensation Calculator and other applicant resources can be found here .

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• State of Missouri

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