RFP Analytical Skills Consultant (Jobs in Bismarck, ND)   Requirement id 120695 Job title Consultant Job location in Bismarck, ND Skills required RFP, Analytical Skills, Offshore Development Team, Open Date 04-Dec-2021 Close Date Job type Contract Duration 12 Months Compensation DOE Status requirement --- Job interview type ---    Email Recruiter: coolsoft Job Description Consultant: RFP, Analytical Skills, Offshore Development Team, Start Date :02/01/2022 Submission Deadline : 01/07/2022 05:00 PM CT Client Info : Auditor, Office of the Description : Position Title: Public Employees Retirement System Prescription Drug Coverage Performance Audit 3.1 SCOPE OF WORK The North Dakota State Auditors Office is soliciting proposals to conduct a prescription drug coverage performance audit of the main public employees retirement system benefit plan. The auditor will analyze claims data and provide recommendations for improvement to the prescription drug coverage benefit. The auditor will obtain a complete set of claims data, meaning line by line claims detail, for the audit period, calendar years 2019, 2020, and 2021, to analyze the items listed in section 3.2. The performance audit will be done in accordance with Government Audit Standards (Yellow Book) issued by the Comptroller General of the United States Government Accountability Office. 3.2 SPECIFIC AUDIT REQUIREMENTS A. REQUIRED ANALYSES When more than one year is required, each analysis shall be broken down by calendar year. The following items are to be analyzed using line by line claims data: 1. Average Wholesale Price pricing errors. a. Analyze claims that were submitted, reversed, and rebilled showing the differences in pricing between the original claim and the resubmitted claim. b. Analyze when the manufacturer updated any pricing information, including WAC and AWP, to determine if there were delays in updating reimbursements to pharmacies. 2. Average annual dispensing fees for brand drugs. 3. Average annual dispensing fees for generic drugs. 4. Average annual ingredient costs for brand drugs by NDC 5. Average annual ingredient costs for generic drugs by NDC. Points 2-5 shall include an average analysis across each of the four matters in the aggregate, and four separate analyses for each of the four matter for drugs dispensed from each of the following four types of pharmacies: a) retail, b) retail 90, c) mail, and d) specialty drug pharmacies. In connection with points 4 and 5, the auditor shall also evaluate the average ingredient cost pricing for brand drugs and for generic drugs and compare said average pricing to the average pricing that would have resulted from the use of pricing based on NADAC. The auditor shall make the above comparison across all brand drugs – and generic drugs – in the aggregate and make such an evaluation across all brand drugs – and generic drugs – by each of the four types of pharmacies listed above. In addition, the auditor shall evaluate the drug-by-drug pricing invoiced to SHP by the PBM and compare said drug-by-drug pricing too the pricing that would have been available based on NADAC data. In connection with points 2-5, the auditor shall also evaluate the PBMs categorization of “brand drugs” and “generic drugs” and compare said categorization to Medi-Span categorization using MONY codes. In addition, the auditor shall evaluate and compare a) the average costs provided during the calendar year, using the PBMs categorization of drugs, with b) the average costs that would have been provided by the PBM, if it used Medi-Span MONY code categorizations, with c) the average costs that the auditor believes were available at the time in the marketplace, using Medi-Span MONY code categorization, and thus provide a market comparison analysis of the pricing that was provided to the State. 6. Administrative fees invoiced. 7. Additional fees invoiced. As part of the analysis related to sections 6 and 7 the auditor shall evaluate the PBMs administrative fees and additional fees and compare each of those fees to the fees that were available in the marketplace. Fees shall be broken down to show differen   Call 502-379-4456 Ext 100 for more details. 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