Managed Care Rebate Analyst

Job Title : Managed Care Rebate Consultant

One of Aston Carter's top clients in the pharmaceutical manufacturing industry is seeking a talented Managed Care Rebate Consultant to join their team! This team consists of 10+ talented professionals and the company prides itself on flexibility, in addition to a great team environment.

The company has one of the best cultures around and is looking for an outgoing individual to add to that. Please see below for further details!

Why you want to work here :

• Excellent opportunity to gain experience with a large, reputable company in the area which is rapidly growing
• Opportunity to work directly with key leaders, including the director of contracts
• Company experienced a very strong financial year in 2023 and is poised for growth in 2024
• Fantastic work culture, flexibility and low turnover rate

Job Description :

The Managed Care Rebate Consultant is responsible for the processing of Managed Care Commercial, Medicare Part D, Managed Medicaid, and Medical Agreement rebate claims in accordance with the terms and conditions of the rebate contract and internal processing procedures.

This position is responsible for analyzing utilization data, applying rules to determine included and excluded claims, assigning appropriate rebate percentages to utilization claims, and initiating payment to customers within contractual guidelines.

• Must have a thorough understanding of PBM networks, drug formularies, and all Managed Care rebate and fee types, including Base Rebates, Administrative Fees, Price Inflation Rebates
• Interpret contract language; input / maintain plans, products, and reimbursement thresholds in the Model N / Flex System
• Analyzes utilization data for completeness and accuracy
• Applies appropriate validations to utilization data; exclude ineligible claims (duplicates, ineligible pharmacies, aberrant quantities)
• Processes rebates through Model N / Flex Revenue Manager Submissions, Adjudications and Settlement Modules, resolving all errors and rejecting lines where appropriate
• Ensures calculated reimbursements are approved at all levels and prepared for payment
• Tracks invoice and calculation amounts; analyzes and explains large variances period over period and invoice vs. calculated amounts
• Assists with system testing as needed
• Maintains and communicates payment calculation details and rejected claim explanation to management and / or customer

Qualifications :

• Bachelors degree in accounting, finance or relevant field
• Experience with Model N / Flex / Revitas
• Validata and Revenue Manager modules
• Validating utilization data from PBMs, Managed Care Contract maintenance, and Managed Care Rebate Processing
• Intermediate Excel skills (Pivot Tables, VLOOKUPs,
• Exemplary analytical skills
• Strong communication skills

Details / Additional Information :

• This position will be a 100% remote opportunity based in the company’s NJ office location (EST hours).
• The standard business hours for this position will be Monday-Friday 9 : 00AM-5PM EST with overtime opportunity as needed.

Please apply today for IMMEDIATE consideration, as we are looking to set up interviews and make a hiring decision by the end of the week!

About Aston Carter :

Aston Carter provides world-class corporate talent solutions to thousands of clients across the globe. Specialized in accounting, finance, human resources, talent acquisition, procurement, supply chain and select administrative professions, we extend the capabilities of industry-leading companies.

We draw on our deep recruiting expertise and expansive network to meet the evolving needs of our clients and talent community with agility and excellence.

With offices across the ., Canada, Asia Pacific and Europe, Aston Carter serves many of the Fortune 500. We are proud to be a ClearlyRated Best of Staffing double diamond winner for both client and talent service.

Diversity, Equity & Inclusion

At Aston Carter, diversity and inclusion are a bridge towards the equity and success of our people. DE&I are embedded into our culture through :

• Hiring diverse talent
• Maintaining an inclusive environment through persistent self-reflection
• Building a culture of care, engagement, and recognition with clear outcomes
• Ensuring growth opportunities for our people

The company is an equal opportunity employer and will consider all applications without regard to race, sex, age, color, religion, national origin, veteran status, disability, sexual orientation, gender identity, genetic information or any characteristic protected by law.