Pharmacist - Rebate Operations & Compliance Expert

Prime Therapeutics; Bismarck (ND); On-site; USD 108,000 - 184,000; Full time

Job summary

Prime Therapeutics LLC is seeking a Rebate Operations Pharmacist to support the rebate operations team and clients. The role interprets Federal legislation affecting state Medicaid Drug Rebate programs and supports DRU reviews and related invoicing activities.

Key duties include SME guidance on claims accuracy, quarterly reporting, and collaboration with leadership on legislative changes, OIG/state audits, and contract compliance.

Qualifications

• PharmD or Bachelor of Science Pharmacy degree
• Current Pharmacist license to practice in the applicable state(s)
• 1 year work experience in Pharmacy or Pharmacy Rebate Management

Responsibilities

• Act as Subject Matter Expert (SME) resource for Rebate Operations team regarding accuracy and reasonableness of medical and pharmacy claims
• Support Rebate Operation and clients in gathering and completion of quarterly 64.9r reporting and ad hoc reporting at client request that aid in showing impacts to rebate programs; assist in pre-invoice claims reviews and adjustments and invoicing activities as needed; assist in dispute resolution as needed
• Partner with team leadership in implementation decisions regarding Federal legislation changes, new reporting creation, and participation in Federal Office of Inspector General (OIG) and state audits; track and ensure all contractual requirements are being met
• Monitor Centers for Medicare & Medicaid Services (CMS) and Medicaid Drug Program (MDP) for new guidance and changes that impact Rebate Operations; provide recommendations on integrating changes
• Partner with Account Management to support rebate trending discussions (e.g., disputes status, program and invoicing trends) and serve as main point of contact for assigned clients on all rebate service-related inquiries
• Other duties as assigned

Education

PharmD or Bachelor of Science Pharmacy degree

Job description

Prime Therapeutics LLC is seeking a Rebate Operations Pharmacist to support the rebate operations team and clients. The role interprets Federal legislation affecting state Medicaid Drug Rebate programs and supports DRU reviews and related invoicing activities.

Key duties include SME guidance on claims accuracy, quarterly reporting, and collaboration with leadership on legislative changes, OIG/state audits, and contract compliance.