| Pharmacy Benefits Management Consultant - Minneapolis, MN (Hybrid) at Minneapolis, Minnesota, USA |
| Email: [email protected] |
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https://jobs.nvoids.com/job_details.jsp?id=2214984&uid= From: Subodh Kumar, TEK INSPIRATIONS LLC [email protected] Reply to: [email protected] Job Description -Pharmacy Benefits Management Consultant Need Candidates LinkedIn and local to Minneapolis, MNRebate Functional Expert We are seeking a highly experienced consultant with proven expertise in pharmacy rebates to oversee and advise on rebate operations within our Pharmacy Benefits Management (PBM) team. This role requires an in-depth understanding of rebate programs, Medicaid Drug Rebate Program (MDRP) compliance, and industry trends. The ideal candidate will have a strong background in rebate management, process improvement, and operational oversight to ensure efficiency, compliance, and optimal rebate financial performance. Key Responsibilities: Rebate Operations Consulting & Oversight: Provide expert guidance on day-to-day rebate operations, ensuring compliance with federal, state, and contractual requirements. Advise on team coordination to drive efficiency, accuracy, and performance in rebate processing. Identify opportunities for process optimization and automation within the rebate system. Serve as an escalation point for rebate-related challenges, collaborating with leadership to implement solutions. Compliance & Audit Support: Ensure adherence to Medicaid Drug Rebate Program (MDRP), OIG, CMS, and state Medicaid contracts. Oversee rebate record management to meet regulatory and audit requirements. Coordinate with external auditors for SOC-1 audits and fulfill OIG and CMS audit requests. Collaborate with IT and compliance teams to implement necessary system changes for ongoing compliance. Technology & Process Improvement: Serve as a strategic advisor between IT and Operations, managing system enhancements and troubleshooting issues. Support improvements in Cognos reporting, ensuring accuracy and efficiency in rebate analytics. Provide recommendations for modernized training techniques to enhance team competency and performance. Lead workflow efficiency projects, working closely with quality and training specialists. Stakeholder & Client Engagement: Act as a subject matter expert (SME) on rebate operations, providing strategic insight into rebate trends and best practices. Partner with external manufacturers, Medicaid clients, and internal stakeholders to enhance rebate performance. Assist the Rebate Director in RFP processes, client-facing meetings, and business growth initiatives. Serve as the primary point of contact for manufacturer eInvoice operations, including registration, updates, and issue resolution. Qualifications & Experience: Required: Extensive knowledge of pharmacy rebates, CMS regulations, and Medicaid Drug Rebate Program (MDRP). 3+ years of experience in rebate, PBM, or pharmacy-related environments, with a strong understanding of rebate operations. Proven ability to analyze and optimize workflows, processes, and compliance metrics in a high-volume operational setting. Strong experience in accounts receivable, collections, and rebate processing. Proficiency in Microsoft Office Suite (Excel), Cognos reporting, and rebate tracking systems. Experience in process improvement and automation within rebate management. Preferred: Retail pharmacy, pharmacy tech, or PBM experience. Background in accounting or finance with an understanding of rebate financials. Experience in operations management, compliance, and auditing in a healthcare setting. Bachelors degree in Accounting, Finance, Business, or a related field (or equivalent experience). Keywords: information technology Pharmacy Benefits Management Consultant - Minneapolis, MN (Hybrid) [email protected] https://jobs.nvoids.com/job_details.jsp?id=2214984&uid= |
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| 04:01 AM 28-Feb-25 |