Medicaid Rebate Operations Analyst

MedImpact Healthcare Systems Inc.; San Diego (CA); On-site; USD 71,614 - 119,953; Full time

Benefits offered by this job

Medical / Dental / Vision Programs

Paid Time Off

401(k) with Company match

Tuition Reimbursement

Employee Referral Bonus

Job summary

MedImpact Healthcare Systems Inc. is seeking a candidate in San Diego to analyze disputed data and assist clients with pharmacy audits. This position requires a BS/BA along with over 5 years of relevant experience, primarily focusing on data analysis and customer service within the healthcare industry.

You will manage invoicing, client reporting, and act as the main contact for state rebate programs. A comprehensive benefits package is included alongside a flexible work schedule.

Qualifications

• 5+ years’ experience or equivalent combination of education and experience.
• 2 years’ subject-matter expertise in respective areas.
• Competent in business intelligence software.

Responsibilities

• Analyze disputed data and resolve disputes with manufacturers.
• Assist with pharmacy audits and payment posting.
• Fulfill client requests for reporting and invoicing.

Skills

Excellent communication skills

Analytical reasoning

Financial reasoning skills

Strong knowledge of pharmacy services

Mathematical skills

Education

BS/BA degree

Tools

Microsoft Word

Microsoft Excel

Microsoft Outlook

Job description

Job Summary

Exemption Status: United States of America (Exempt)

Pay range: $71,614 - $95,784 - $119,953. 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; it is always dependent on actual experience, education, qualifications, and other factors.

Essential Duties and Responsibilities

• Analyze disputed data and work with drug manufacturers to fairly and accurately resolve disputes.
• Assist clients with pharmacy audits, providing requested information and support.
• Assist with payment posting, collections, and maintain all client service agreements.
• Execute billing processing for over 800 manufacturers per program; perform quality assurance activities and correct 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.
• Perform provider audits to verify product and quantity dispensed.
• Send out past‑due notices to drug manufacturers.
• Act as the main point of contact for the State for all rebate programs.
• Perform monthly and quarterly financial reconciliation with the State.
• Fulfill client requests for reporting, invoicing, and any other rebate‑related needs.
• Attend meetings and conference calls as needed.

Client Responsibilities

• Provide excellent customer service skills and interpersonal communication skills (listening/verbal/written).
• 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

• Education and/or Experience: BS/BA and 5+ years’ experience or equivalent combination of education and experience, and 2 years’ subject‑matter expertise in respective areas.
• Computer Skills: Competent with Microsoft Word, Excel, and Outlook; expected to develop competence with MedInvoice rebate system or other business intelligence software, as well as with proprietary systems/databases used by MedImpact.
• Other Skills and Abilities:
  • 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.
  • Ability to interpret instructions in written, oral, diagram, or schedule form.
  • Ability to define problems, collect data, establish facts, and draw valid conclusions.
  • Mathematical skills: Apply fractions, percentages, ratios, proportions, discounts, interest, commissions, basic algebra, and geometry to practical situations.
  • Language skills: Effectively present information and respond to questions from managers, clients, customers, and the general public; write reports, business correspondence, and procedure manuals.
• Physical Demands: Regularly required to sit, talk, stand, walk, use hands; occasionally lift or move up to 25 pounds. Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.

Benefits

• Medical / Dental / Vision / Wellness Programs
• Paid Time Off / Company Paid Holidays
• Incentive Compensation
• 401(k) with Company match
• Life and Disability Insurance
• Tuition Reimbursement
• Employee Referral Bonus

Work Location and Hours

Position works on‑site at the San Diego Headquarters or other company location (or from a remote location with management approval). The core business hours are Monday through Friday from 8:00am to 5:00pm. The incumbent must have the flexibility to work beyond traditional hours and may be required to work nights, weekends, or holidays as needed.

Equal Opportunity Statement

Equal Opportunity Employer, Male/Female/Disabilities/Veterans. OSHA/ADA: Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.