Employer Industry: Pharmaceutical Manufacturing
Why consider this job opportunity…
– Opportunity to gain experience with a large, reputable company that is rapidly growing
– Work directly with key leaders, including the director of contracts
– The company experienced a strong financial year in 2023 and is poised for growth in 2024
– Fantastic work culture, flexibility, and low turnover rate
– 100% remote work opportunity based in NJ with standard business hours of Monday-Friday, 9:00 AM – 5:00 PM EST
What to Expect (Job Responsibilities):
– Process Managed Care Commercial, Medicare Part D, Managed Medicaid, and Medical Agreement rebate claims according to rebate contracts and internal procedures
– Analyze utilization data to determine included and excluded claims and apply appropriate rebate percentages
– Interpret contract language and maintain plans, products, and reimbursement thresholds in the Model N/Flex System
– Process rebates through Model N/Flex Revenue Manager Submissions, resolving errors and rejecting lines as necessary
– Communicate payment calculation details and rejected claim explanations to management and/or customers
What is Required (Qualifications):
– Bachelor’s degree in accounting, finance, or a relevant field
– Experience with Model N/Flex/Revitas and Validata and Revenue Manager modules
– Experience validating utilization data from PBMs, Managed Care Contract maintenance, and Managed Care Rebate Processing
– Intermediate Excel skills, including Pivot Tables and VLOOKUPs
– Strong analytical and communication skills
How to Stand Out (Preferred Qualifications):
– Experience in analyzing utilization data for completeness and accuracy
– Familiarity with PBM networks and drug formularies
– Previous experience in Managed Care rebate and fee types, including Base Rebates and Administrative Fees
– Strong problem-solving skills and attention to detail
– Ability to assist with system testing as needed
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To apply for this job please visit topsiksha.com.
