Analyst, Government Reimbursement

Make your mark for patients

We are looking for a Government Reimbursement Analyst to join us in our Market Access & Pricing team , based in Atlanta, GA.

This hybrid role (at least 40% of the time in office) requires up to 10% travel domestically.

About the Role

The Government Reimbursement Analyst is responsible for a range of activities related to the payment of Government Programs, including State Medicaid, Coverage Gap, TriCare, & Federal Supply Schedule (FSS), Industrial Funding Fee (IFF).

Who you’ll work with

Internally, you will work with Accounting and Finance, Government Pricing, Gross 2 Net (G2N) teams, Regional Account Executives as required, SAP team (IT), & Market Access partners.

Externally, you will work with the State Medicaid Agencies, Model N and external analysts and legal consultants.

What you’ll do

• Manage contracts and pricing updates & process payments related to assigned Government programs
• Manage Medicaid Payment Master for all assigned programs
• Procure State invoices and Claim Level Detail (CLD) reports from state or PBM portal as required. Processes all Medicaid claims and other programs as assigned within required period
• Serve as the key contact with State Medicaid agencies and must be able to communicate clearly and reconcile discrepancies within required timeframes
• Analyze summarizes and interprets results and makes recommendations regarding the need to dispute any submission
• Responsible for the settlement of programs in both Model N and SAP and managed system testing and system upgrades as assigned
• Ensure compliance with applicable federal and / or state laws, regulations, and / or agency rules, standards, and guidelines, etc.

Interested? For this role we’re looking for the following education, experience and skills

• Bachelor’s degree in Finance, Accounting, or other analytical-related field; will consider candidates with Pharmacy Tech Certificate with pharmacy claims or pharmacy manufacturer experience in lieu of a Bachelor’s degree
• 2+ years of relevant experience required.
• Pharmacy Benefit Management (PBMs), pharmacy claims knowledge and / or pharmacy-related experience is preferred
• Working knowledge of government regulations pertaining to Federal and State Medicaid programs preferred
• Strong MS Excel working knowledge; SAP & Model N preferred
• Hands-on knowledge of and / or experience with Model N or other Government Pricing software platforms strongly preferred

This positions reasonably anticipated salary range is $81,000 106,000. The actual salary offered will take into account related knowledge, skills, experience and candidate location among other factors and may fall outside the expected range.

Are you ready to go beyond’ to create value and make your mark for patients? If this sounds like you, then we would love to hear from you!