Pharmacy Benefits Market Examiner
Posting Begin Date: 2025/09/05
Work Type: Full Time
Location: Boise, ID, United States
Minimum Salary: 32.97
Maximum Salary: 37.09
Pay Rate Type: Hourly
Description
Idaho Department of Insurance Career Opportunity
This position will remain open until it is filled; the posting will be taken down once a candidate is selected.
The Idaho Department of Insurance (https://doi.idaho.gov/) (DOI) is searching for a Pharmacy Benefit Market Examiner. This position is a full-time benefited position in downtown Boise.
This position is in the Market Oversight Bureau and will report directly to the Bureau Chief.
This position is responsible for a variety of regulatory activities related to pharmacy benefit managers including compliance. We are looking for an individual who has a passion for protecting Idahoans and a deep understanding of pharmacy benefits, as well as excellent communication skills.
Hiring managers are continuously reviewing applications for this position. We highly encourage individuals to apply quickly for this great opportunity at DOI!
HOW TO APPLY
After careful review of this announcement, please make sure to attach and submit:
A resume - relevant to this position.
A list of three (3) professional references - detailing the length and nature of your association.
A cover letter - detailing your position-related background and experience. Make sure to include any insurance, market conduct, or pharmacy benefit conduct related experience.
The ideal candidate has:
A broad understanding and professional experience working with pharmacy benefit managers, pharmacy insurance contracts, or a related area.
An understanding and respect for the Idaho Insurance Code.
Compelling customer service and a desire to assist Idahoans.
The ability to clarify and explain complex issues in understandable terms.
Critical thinking and collaboration to solve complex problems. This includes the ability to think proactively within a changing landscape when making decisions.
EXAMPLE OF DUTIES
Conduct activities related to pharmacy benefit compliance, which may include overseeing work of contractors.
Implement reporting requirements for Pharmacy Benefit managers in accordance with regulation.
Investigate complaints related to Pharmacy Benefit Managers.
Take steps to identify, diagnose and resolve areas of concern related to pharmacy benefits and pharmacy benefit managers.
Perform specialized analysis of pharmacy benefit managers by reviewing required reporting, complaints, and other related information.
Confer with and advise management regarding insurance company compliance with Idaho Code, federal regulations, informational bulletins, and attorney general opinions affecting the insurance industry.
Prepare written workpapers to illustrate and document work accomplished and demonstrate achievement of the agency market analysis and examination objectives.
Work closely with staff and attorneys regarding legal matters, represent the department in administrative actions and testify in hearings when needed.
MINIMUM QUALIFICATIONS
Essential:
Good knowledge of insurance, pharmacy benefits or financial industry regulation.
Good knowledge of research and analysis methods and statistical techniques.
Experience compiling and analyzing statistical data, drawing conclusions, and presenting recommendations verbally and in written form.
Analysis of complex issues.
Experience interpreting and applying federal and state laws, rules, and directives.
Desired Qualifications:
Two (2) years of experience as a pharmacy benefit plan administrator, or similar position; or equivalent education such as a degree in pharmacy;
Possess professional designations or licenses such as pharmacist license, pharmacy technician license MCM, AIE, CIE, APIR or PIR;
Direct regulatory experience and/or a deep understanding of the insurance industry with an emphasis in pharmacy benefits and compliance with laws and regulations;
Bilingual fluency in reading, writing, and speaking Spanish is preferred but not required.
SUPPLEMENTAL INFORMATION:
Occasional work-related travel may be required throughout the year.
This position is exempt from classified state service and the rules of the Division of Human Resources and the Idaho Personnel Commission.
The mission of the Department of Insurance is to serve and protect Idahoans by equitably, effectively, and efficiently administering the Idaho Insurance Code and the International Fire Code.
The Department of Insurance is in downtown Boise across the street from the state's Capitol Building. Boise consistently receives top accolades as one of the best places to live in the country! To learn more about Idaho DOI and the important work we do, go to the DOI website (https://doi.idaho.gov/%22%20/t%20%22\blank) , and follow us on Facebook (https://www.facebook.com/people/IdahoDOI-Speaker/pfbid098kwPLukACpEGXMhW3ca4izbhFriKduK4cJhgyQWrgVyd689uZzEcBDQpB7fe3hhl/%22%20/t%20%22\blank) , X (Formerly Twitter) (https://twitter.com/IdahoDOI%22%20/t%20%22\blank) and LinkedIn (https://www.linkedin.com/in/doi-boise-618942160/%22%20/t%20%22\blank) .
BENEFITS
This benefited position enjoys:
Excellentmedical, dental, and vision insurance (https://ogi.idaho.gov/) health plans
Nationally recognizedPERSI (https://www.persi.idaho.gov/) retirement benefits
Paid sick and vacation leave accrual upon hire
Paid parental leave (https://dhr.idaho.gov/information-for-state-employees/)
11 paid holidays annually
A healthy work-life balance
Career growth and professional development opportunities
For additional information related to benefits and/or State programs visit: https://dhr.idaho.gov/StateEmployees/Benefits.html. (https://dhr.idaho.gov/StateEmployees/Benefits.html.%22%20/t%20%22_blank)
EEO/ADA/VETERAN
The State of Idaho is committed to providing equal employment opportunities and prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on their race, color, religion, political affiliation or belief, sex, national origin, genetics, or any other status protected under applicable federal, state, or local laws.
The State of Idaho is committed to access and reasonable accommodations for individuals with disabilities, auxiliary aids and services are available upon request. If you require an accommodation at any step in our recruitment process, you are encouraged to contact (208) 334-2263 (TTY/TTD: 711), or email [email protected] .
Preference may be given to veterans who qualify under state and federal laws and regulations.
