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Senior Commercial Rebate Analyst

Remote: 
Full Remote
Contract: 
Experience: 
Mid-level (2-5 years)
Work from: 

Offer summary

Qualifications:

Minimum 2 years in contracting or administration, Experience with rebate claims adjudication systems, Knowledge of Managed Care and PBMs, Familiarity with pharmacy and medical contracting, Understanding of NCPDP rebate standards.

Key responsabilities:

  • Lead day-to-day activities of Rebate Analysts
  • Review calculations for accuracy and compliance
  • Assist in training development for recruits
  • Support client onboarding and testing processes
  • Maintain relationships with assigned pharmaceutical clients
Envision Pharma Group logo
Envision Pharma Group Pharmaceuticals Large https://www.envisionpharmagroup.com/
1001 - 5000 Employees
See more Envision Pharma Group offers

Job description

Work where you can be your best you. Join Two Labs proudly part of Envision Pharma Group, as we continue to grow our business!


Two Labs, founded in 2003, is a leading pharmaceutical services company that partners with pharma/biotech companies. At Two Labs, we understand no two product paths are alike. We deliver integrated and customized commercial solutions, helping to chart the path from clinical to commercial for a new product launch and provide strategies for continued market viability for drugs on the market.


Two Labs has a proven track record of successful launches across all major therapeutic areas with unmatched client satisfaction. Two Labs expanded its presence in the pharma consulting space both through organic growth and acquisitions. In 2020, we added the talent of CEEK Enterprises, our Strategic Consulting Team, who specializes in pharma management consultancy. Riparian – a fully integrated Professional Services firm providing consulting services, managed services, and software as a service (“SaaS”)/software solutions to the pharmaceuticals/ life sciences industry joined the Two Labs family in 2021. Two Labs is a highly collaborative, friendly, passionate, and energized team of professionals who work in an environment that goes beyond casual dress and flex scheduling. No structure or formality is permitted to get in the way of collaboration and teamwork. The ongoing growth of the company offers team members continuous opportunities to gain experience, develop skills and chart their course along an exciting success path.


Thanks to our reputation and unique business model, Two Labs is growing, and as part of our continued growth, we're looking for dynamic and highly motivated new talent to grow and thrive right along with us.


What is the opportunity?


As a Senior Commercial Rebates Analyst, you would support the day-to-day activities and deliverables of a Rebate Analyst. You would also support a variety of pharmaceutical clients' needs based on contracted services outlined in the Statements of Work (SOWs), with a primary focus around the calculation and generation of various reimbursement payments related to Commercial, Medicare Part D and other reimbursement type client agreements.


How will you make an impact?


Role responsibilities


  • Lead and support the day-to-day activities and deliverables of Rebate Analysts.
  • Review calculations and work product of assigned Rebate Analysts, ensuring accuracy and adherence to applicable policies.
  • Assist with new hire and ongoing training and development of Rebate Analysts.
  • Assist with the development and maintenance of rebate training materials (e.g., training manual, videos, quality control checklists) to support new hires.
  • Support new client onboarding activities, engaging appropriate teams as needed.
  • Perform user acceptance testing for any rebate adjudication or reporting systems (e.g., new system, enhancements to existing) that support rebate processes.
  • Work with internal teams to develop UAT scripts and test scenarios.
  • Support assigned clients, building and maintaining the relationship and ensuring services are fulfilled through the terms of the Statements of Work (SOW).
  • Provide customer service and communication to client(s) on all applicable issues and deliverables, elevating potential issues to management as needed (particularly, issues outside scope of SOW).
  • Provide support to assigned pharmaceutical clients on a variety of Commercial, Medicare Part D and other reimbursement payment and analytical related functions.
  • Responsible for the timeliness, accuracy and compliance of all Commercial/Medicare Part D, or other reimbursement type payments issued to payers/processors/PBMs on behalf of assigned client(s).
  • Identify and interpret critical key components (e.g., key payment terms, pricing schedules, excluded claims language and formulary and benefit design requirements) for assigned client Commercial/Medicare Part D or other reimbursement agreements that translate into accurate contract set-up in system for claims adjudication and payment.
  • Reconcile rebate invoices received by Commercial/Medicare Part D and/or other processors/payers against claim or transactional level data.
  • Conducts complete analysis of data against contract terms and other variables (e.g., pricing, formulary/benefit design statuses), investigating discrepancies and work with clients and/or contracted entities on resolution prior to issuance of payments.
  • Interpret contract language with regards to product(s) formulary/benefit design requirements and evaluate against payer/PBM/Plan documentation (e.g., Product Drug Listings, plan formulary/benefit design structures or Prior Authorizations), to conduct compliance checks against invoiced claims to determine rebate eligibility.


Do you have what we're looking for?


Skills & Expertise


  • Minimum of 2 years Commercial/Medicare Part D contracting and/or contract administration, and formulary and benefit design interpretation experience required.
  • Minimum of 2 years industry systems/software supporting rebate claims adjudication (e.g., Model N) experience required.
  • Knowledge of Managed Care landscape and Pharmacy Benefit Managers (PBM) structures/invoicing behaviors.
  • Knowledge of Commercial pharmacy and Medical Benefit contracting and contract administration.
  • Knowledge of pharmaceutical industry rebate claims adjudication systems/tools.
  • Knowledge of NCPDP (National Council for Prescription Drug Programs) Managed Care rebate standards.
  • Knowledge of various data validation methodologies and standards, spanning Commercial pharmacy and Medical Benefit agreements.
  • Skilled with client interactions (e.g., anticipating needs ahead of time, ability to negotiate or push back on timelines).


#TogetherWeDiscover


We turn vision into reality. Our people are integral to our success and our values reflect the Envision philosophy where our teamwork helps us all grow and our enthusiasm inspires each other.


Our Envisionary culture is a special environment that gives every employee a voice the space to invent and the chance to excel. A place where, every day, people laugh, think, take risks, and are excited about the possibilities the day brings.


Explore your place at Envision. If you have the experience highlighted above, we would love to hear from you!

Required profile

Experience

Level of experience: Mid-level (2-5 years)
Industry :
Pharmaceuticals
Spoken language(s):
English
Check out the description to know which languages are mandatory.

Other Skills

  • Training And Development
  • Analytical Thinking
  • Verbal Communication Skills

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