Medicaid Rebate Operations Analyst

Exemption Status:

“Pay scale information is not necessarily reflective of actual compensation that may be earned, nor a promise of any specific pay for any selected candidate or employee, which is always dependent on actual experience, education, qualifications, and other factors.  A full review of our comprehensive pay and benefits will be discussed at the offer stage with the selected candidate.”

This position is not eligible for Sponsorship.

MedImpact Healthcare Systems, Inc. is looking for extraordinary people to join our team!

Why join MedImpact? Because our success is dependent on you; innovative professionals with top notch skills who thrive on opportunity, high performance, and teamwork. We look for individuals who want to work on a team that cares about making a difference in the value of healthcare.

At MedImpact, we deliver leading edge pharmaceutical and technology related solutions that dramatically improve the value of health care. We provide superior outcomes to those we serve through innovative products, systems, and services that provide transparency and promote choice in decision making. Our vision is to set the standard in providing solutions that optimize satisfaction, service, cost, and quality in the healthcare industry. We are the premier Pharmacy Benefits Management solution!

Job Description

Summary  

This position is responsible for all drug rebate activities, both financial and operational.  This includes the processing of quarterly rebate invoices, preparing and delivering monthly and quarterly rebate reports and working through dispute resolution process with manufacturers.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Analyzes disputed data and works with drug manufacturers to fairly and accurately resolve disputes.
• Assists clients with Pharmacy audits providing requested information and support.
• Assisting with payment posting, collections, and maintaining all client service agreements.
• Executes billing processing for over 800 manufacturers per program; performs quality assurance activities and corrects any errors prior and post invoice generation within timelines required under contract.
• Invoicing practices, including pre-invoicing review for fee for service, managed care, diabetic supply and supplemental rebate programs.
• Review drug rebate claims for errors that will impact invoicing.
• Performs provider audits in order to verify product and quantity dispensed.
• Sends out past due notices to drug manufacturers.
• Main point of contact for State for all rebate programs.
• Performs monthly and quarterly financial reconciliation with the State.
• Fulfills client requests for reporting, invoicing and any other rebate related needs.
• Attends meetings and conference calls as needed.

Supervisory Responsibilities

No supervisory responsibilities

Client Responsibilities

This is an internal and external client facing position that requires excellent customer service skills and interpersonal communication skills (listening/verbal/written).  One must be able to; manage difficult or emotional client situations; Respond promptly to client needs; Solicit client feedback to improve service; Respond to requests for service and assistance from clients; Meet commitments to clients.

Qualifications

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Education and/or Experience

BS/BA and 5+ years’ experience or equivalent combination of education and experience, and 2 years' of SME in respective areas

Computer Skills

To perform this job successfully, an individual must be competent with Microsoft Word, Excel, and Outlook software. The individual is expected to develop competence with MedInvoice rebate system or other business intelligence software, as well as with proprietary systems/databases used by MedImpact.

Certificates, Licenses, Registrations

None required.

Other Skills and Abilities

• Possess excellent communication skills (both verbal and written), analytical and/or financial reasoning skills.
• Familiar with service contracts and contract interpretation.
• Strong knowledge of pharmacy services with an emphasis on the managed health care environment.

Reasoning Ability             

• Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form.
• Ability to define problems, collect data, establish facts, and draw valid conclusions.

Mathematical Skills

• Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
• Ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume.  Ability to apply concepts of basic algebra and geometry.

Language Skills

• Ability to effectively present information and respond to questions from groups of managers, clients, customers, and the general public.
• Ability to write reports, business correspondence, and procedure manuals. 

Competencies To perform the job successfully, an individual should demonstrate the following competencies:

Composure

Decision Quality

Organizational Agility

Problem Solving

Customer Focus

Drive for Results

Peer Relations

Time Management

Dealing with Ambiguity

Learning on the Fly

Political Savvy

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

While performing the duties of this Job, the employee is regularly required to sit and talk or hear. The employee is regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms. The employee must occasionally lift and/or move up to 25 pounds.

Work Environment

The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

This position may regularly be exposed to or encounter moving mechanical parts, high, precarious places, fumes or airborne particles, toxic or caustic chemicals, outdoor weather conditions, risk of electrical shock or vibration. The noise level in the work environment is usually moderate (examples: business office with computers and printers, light traffic).

Work Location

This position works on-site at the San Diego Headquarters or other company location (or from a remote location with management approval based on business requirements). Must provide adequate support to internal clients; be available for regular interactions and coordination of work with other employees, colleagues, clients, or vendors; as well as be available to facilitate effective decisions through collaboration with stakeholders.

Working Hours

This is an exempt level position requiring the incumbent to work the hours required to fully accomplish job responsibilities and reasonable meet deadlines for work deliverables. The individual must have the flexibility to work beyond traditional hours and be able to work nights, weekends or on holidays as required.  Work hours may be changed from time to time to meet the needs of the business.  Typical core business hours are Monday through Friday from 8:00am to 5:00pm.

Travel

This position requires no travel however attendance may be required at various local conferences and meetings.

The Perks:

• Medical / Dental / Vision / Wellness Programs

• Paid Time Off / Company Paid Holidays

• Incentive Compensation

• 401K with Company match

• Life and Disability Insurance

• Tuition Reimbursement

• Employee Referral Bonus

To explore all that MedImpact has to offer, and the greatness you can bring to our teams, please submit your resume to www.medimpact.com/careers

MedImpact, is a privately-held pharmacy benefit manager (PBM) headquartered in San Diego, California. Our solutions and services positively influence healthcare outcomes and expenditures, improving the position of our clients in the market. MedImpact offers high-value solutions to payers, providers and consumers of healthcare in the U.S. and foreign markets.

Equal Opportunity Employer, Male/Female/Disabilities/Veterans

OSHA/ADA:

To perform this job successfully, the successful candidate must be able to perform each essential duty satisfactorily. The requirements listed are representative of the knowledge, skill, and/or ability required.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Disclaimer:

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not intended to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.