Benefit Program Senior Specialist

State-of-Missour; Jefferson City (MO); On-site; USD 44,000 - 53,000; Full time

Job summary

The State-of-Missour MO HealthNet Division seeks a Benefit Program Senior Specialist in the Medicaid Drug Rebate Unit in Jefferson City, MO. The role focuses on managing pharmaceutical manufacturer accounts and ensuring accurate drug rebate activities.

You will analyze claims data, resolve disputes, prepare reconciliation documentation, and monitor compliance with CMS requirements for the MDRP. This is a state civil service opportunity with benefits.

Qualifications

• Bachelor's degree and 1-3 years of relevant experience.
• Experience within a pharmaceutical setting or billing pharmaceutical claims preferred.
• Strong written and verbal communication skills.
• Ability to plan, organize and prioritize work.

Responsibilities

• Manage pharmaceutical manufacturer accounts as assigned.
• Resolve disputes submitted by pharmaceutical manufacturers in response to invoices.
• Prepare routine reports and documentation to reconcile outstanding balances.
• Analyze and evaluate claims to identify patterns of utilization and potential abuse.
• Review payment data to identify recoupment or adjustment of claims.
• Monitor operations for CMS MDRP compliance and respond to inquiries.
• Locate and analyze information from various sources related to the MDRP.
• Communicate program requirements to manufacturers, providers and coworkers.
• Participate in meetings to identify problems and develop solutions.

Skills

Communication skills

Planning and prioritization

Education

Bachelor's degree

Job description

The MO HealthNet Division has an opening for a Benefit Program Senior Specialist within the Medicaid Drug Rebate Unit located in Cole County. Semi-monthly salary: The current rate for this position is $2,020.69. Individual(s) selected for this position may receive a higher rate based on a pay differential (e.g. shift, or time-of-service pay).

Annual Salary: $48,496.56. Job Posting Number: 4591 8260011. 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:

This position is in a small unit of 9 staff members who work closely together to collect rebates from pharmaceutical manufacturers. The work can be challenging but the rewards are big as the funds collected largely impacting the overall budget for MO HealthNet.

What you’ll do:

• Manage pharmaceutical manufacturer accounts as assigned.
• Resolve disputes submitted by pharmaceutical manufacturers in response to invoices generated from drug claims data.
• Prepare routine reports and documentation needed to reconcile pharmaceutical manufacturer outstanding balances.
• Analyze and evaluate claims to identify patterns of utilization to recognize possible abuse or errors in claim filing.
• Review and evaluate detailed payment data from reports in order to identify and initiate recoupment and/or adjustment of claims.
• Monitor unit and program operations, regulations, procedures and audit recommendations to ensure compliance with Centers for Medicare and Medicaid Services (CMS) for the Medicaid Drug Rebate Program (MDRP).
• Answer program inquiries from providers and pharmaceutical manufacturers.
• Locate, organize, and perform routine analysis on information from various sources pertaining to all aspects of the Medicaid Drug Rebate Unit.
• Communicate effectively with manufacturers, providers and co-workers regarding program requirements related to the MDRP.
• Participate with other staff members in meetings to identify problem areas and develop solutions; and perform other related work as assigned

Minimum Qualifications:

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

Preferred Qualifications:

• Experience within a pharmaceutical setting (working as a pharmaceutical technician or billing pharmaceutical claims)
• Experience with collections
• Ability to plan, organize and prioritize work
• Good written and verbal communication skills

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.

If you have questions about this position, please contact: Jaime Jones at [e-mail]. If you experience accessibility issues while applying, please contact Courtney Hall at [e-mail].

Recruitment Area: All qualified applicants.

Application Deadline: September 8, 2026.