Senior Consultant, Managed Care Rebates

Envision Pharma Group; United States; On-site; USD 94,000 - 122,000; Full time

Job summary

Envision Pharma Group is seeking a Senior Consultant to provide strategic guidance to healthcare organizations on managing relationships with insurers and optimizing reimbursement. You will analyze contracts, evaluate payment models, and develop strategies to improve cost-effectiveness and quality of care, while ensuring regulatory compliance and strong financial analysis.

You will collaborate with cross-functional teams to support contract administration, rebates, and formulary reviews.

Qualifications

• Minimum 5 years of managed care consulting, healthcare finance, or payer contracting.
• Minimum 2 years of managed care contract negotiating with improved financial performance.

Responsibilities

• Manage executed managed care contracts from system entry through rebate validations and payment.
• Ensure accurate and timely processing of accounts including rebates, validation, reporting, and correspondence.
• Perform data analysis to adjudicate rebates according to contract terms.
• Review formulary on a quarterly basis to verify product positions on contracts.
• Set up and maintain contracts in rebate adjudication systems reflecting contract terms.
• Review financial, membership and utilization reports to monitor trends.
• Collaborate with multiple departments to facilitate information exchange with customers.
• Serve as liaison between management and customers to resolve disputed rebate data.

Skills

Managed care consulting

Payer contracting

Contract negotiation

Financial analysis

cross-functional collaboration

Education

Bachelor's degree in Healthcare/Accounting/Finance/Business Administration/Tech

Job description

Analyze, Advise, Deliver—Your Consulting Career Starts Here

Work shouldn't just be something we do; it should have a purpose. At Envision, we believe in creating life-changing outcomes through the work we do with our clients, giving back to our communities, while creating a company culture where our people thrive. We believe success starts with a workplace where everyone feels valued, supported, and empowered to grow.

Being part of a collaborative team means there's no limit to what you can achieve. With us, you can be a part of a growing company you want to work for.

Our Vision:

To unleash the power of combined intelligence to accelerate patient access to life-changing treatments.

Our Mission:

Delivering smarter and faster solutions to create, communicate, and commercialize value for our clients.

Our Values:

Excellence, People, Growth

The opportunity

At Riparian, we offer innovative software, expert consulting, and outsourcing solutions to the life sciences industry. Our comprehensive solutions help manufacturers navigate the complexities of revenue management, government pricing, revenue leakage, contracting strategy, and more. With a client-focused approach, we drive transformative outcomes, ensuring regulatory success and operational efficiency.

As a Senior Consultant, you'll be responsible for providing strategic guidance and support to healthcare organizations in managing their relationships with insurance providers and optimizing reimbursement for services. You will analyze and negotiate contracts, evaluate payment models, and develop strategies to improve cost-effectiveness and quality of care. You will also provide expertise on regulatory compliance, network development, and financial analysis.

How will you make an impact at Envision Pharma Group?

Role responsibilities

• Manage executed managed care contracts from system entry through to rebate validations and payment using multiple systems in li">a timely li"> and compliant manner.
• Ensure li">accurate li"> and li">timely li"> processing of assigned accounts including system entry, rebates, validation, reporting, correspondence, and all other aspects of commercial contract administration.
• Perform detailed analysis and validation of rebate claim data li">in order to li"> accurately li"> adjudicate li">the managed li"> care rebates according to the terms specified in the contracts.
• Perform li">formulary li"> review on a quarterly basis to confirm li">formulary li"> position of products on contract.
• Set up and li">maintain li"> contracts li">pertaining to li"> assigned accounts in rebate adjudication system and ensure that they li">properly reflect li"> the contract terms and requirements.
• Reviews key financial, membership and li">utilization li"> report to li">monitor li"> trends and research any significant changes in li">utilization li">.
• Collaborates with team members across multiple departments to li">facilitate li"> the exchange of information, address needs, and clarify contract requirements with internal and external customers.
• Serve as liaison between management and customers li">in order to li"> resolve any disputed rebate claim data.

Do you have what we are looking for?

Skills & expertise

• Bachelor's degree in Healthcare li">, Accounting/ Finance, Business Administration or Technology related field li">required li">.
• Minimum 5 years of managed care consulting, healthcare finance, or payer contracting li">required li">.
• Minimum 2 years of managed care contract negotiating with improved financial performance li">required li">.

Salary range:

$93,800 - $122,000

The provided salary range reflects the potential base salary for this role in the United States,considering factors such as your professional and academic experience, training, and role responsibilities. In addition to a competitive base salary, we offer an attractive total compensation benefits package designed to reward and support our people.

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