Medicaid PDL and Rebate Strategy Manager

MedImpact Healthcare Systems, Inc.; California (MO); Remote; USD 108,000 - 153,000; Full time

Job summary

An established industry player is seeking a Medicaid PDL and Rebate Strategy Manager to lead the maintenance of their Medicaid Fee-For-Service and supplemental drug rebate programs. In this pivotal role, you will collaborate with various teams to ensure compliance and enhance brand visibility in the Medicaid market. Your expertise will help shape the future of healthcare solutions by driving strategic initiatives and fostering relationships with stakeholders. If you are passionate about making a difference in healthcare and have a strong background in operational management and Medicaid programs, this opportunity is perfect for you.

Benefits

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

Qualifications

• 3+ years operational management experience in State Rebate Programs required.
• Must have in-depth understanding of CMS Medicaid Drug Rebate Program.

Responsibilities

• Maintain Medicaid supplemental rebate and Preferred Drug List strategy.
• Collaborate with internal partners to develop business requirements.
• Oversee state client contracts and ensure customer satisfaction.

Skills

Operational Management

Medicaid Drug Rebate Programs

Pharmaceutical Industry Knowledge

Data Analysis

Education

Doctor of Pharmacy (Pharm.D.)

Registered Pharmacist (RPh)

Tools

Reporting and Analytics Tools

Job description

Medicaid PDL and Rebate Strategy Manager

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Remote type: Remote

Locations: Remote

Time type: Full time

Posted on: Posted 30+ Days Ago

Job requisition ID: JR101352

Exemption Status:

United States of America (Exempt)

Salary Range: $108,515 - $152,464 - $196,412

Note: Pay scale information is not necessarily reflective of actual compensation that may be earned. Actual pay depends on experience, education, qualifications, and other factors.

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.

Job Description

Summary: The Medicaid PDL & Rebate Strategy Manager is responsible for the maintenance of MedImpact’s Medicaid Fee-For-Service (FFS) and supplemental drug rebate program. This position assists with the Supplemental Medicaid Drug Rebate Program and ensures compliance with the program requirements. This role works collaboratively with MedImpact SMEs (subject matter experts), consultants, sales, marketing, and senior leadership to create brand awareness and visibility in the Medicaid FFS market.

Essential Duties and Responsibilities include the following:

• Assists in maintaining a CMS compliant Medicaid supplemental rebate and Preferred Drug List strategy and program.
• Helps to identify, develop, and manage the infrastructure needed to support and evolve the Company’s Medicaid FFS supplemental rebate program.
• Collaborates with internal partners to lead in the identification, documentation, and development of business and system requirements necessary to support partner programs and enhancements.
• Works with cross-functional subject matter experts in IT, analytics, operations, and sales to support MedImpact’s emerging Medicaid FFS product line.
• Develops, reviews, publishes, and maintains policy and procedure (P&P) documents for: (1) Medicaid FFS supplemental rebate guarantee management, (2) outlining the processes to determine rebate outcomes and modeling, (3) contract documentation.
• Researches new program offerings and enhancements related to both supplemental and federal rebates.
• Makes recommendations for specific state program improvements based on program performance analytics and utilization trend data.

Supports MedImpact’s Clients

• Develops and implements processes to keep internal/external customers up to date on: (1) changes made by manufacturers, (2) specific states’ requirements, (3) CMS, and (4) MedImpact rebate processes and policies that impact the rebate program and related activities.
• Develops models that enable assessment of the impact of changes and communication of program changes.
• Understands and interprets customer fiscal and operational needs in support of MedImpact business goals and retention planning for each state contract.
• Oversees state client contracts to ensure all state/federal deadlines are met and customer satisfaction is met or exceeded.
• Attends specific state focused internal and external meetings to address all topics and concerns.
• Develops good working relationships with internal and external stakeholders; communicates with clients professionally and proactively responds to inquiries. Attends identified conferences and sales meetings.

Supports the Fee-for-Service Rebates Program

• Collaborates with the Rebate Operations Director on new implementations to ensure that supplemental and federal rebate files and data are complete and tested for validity.
• Identifies and develops opportunities to manage or mitigate risk specific to each state Medicaid rebate program.
• Works with reporting team to develop and deploy accurately configured standard and state specific rebate reports and provides guidance to state resources as necessary to generate ad-hoc reports using MedImpact reporting and analytics tools.
• Resolves escalated issues regarding state Medicaid supplemental rebate programs.

Other duties and projects as assigned

• Defines/manages all aspects of assigned projects to ensure completion that meets defined scope, quality, and time constraints.
• Supports internal and external state audit preparation and execution.
• Keeps up to date with industry changes and best practices.

Education and/or Experience

Doctor of Pharmacy (Pharm.D.) / Registered Pharmacist (RPh) (or equivalent combination of education and experience) required along with 3+ continuous years’ operational management experience in State Rebate Programs (Federal and Supplemental) required. Must have 3+ years’ recent experience working with Medicaid drug rebates and/or applicable Medicaid data. Must have prior experience and in-depth understanding of (1) CMS Medicaid Drug Rebate Program, (2) state supplemental rebate programs, (3) drug pipelines, (4) pharmaceutical manufacturing industry, (5) state fiscal planning and reporting, and (6) clinical value of medications.

Certificates, Licenses, Registrations

Registered and Licensed Pharmacist in good standing in at least one state is required.

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.