Director, Pharmacy Rebate Operations

Albany NY 12203

Job Description

Responsible for overseeing the day-to-day activities of the Medicaid Rebate Operations function to ensure appropriate rebating and reconciliation of formulary prescription drugs. Primary duties include: ensuring all data is submitted by States, Manufacturers and clients in a timely and compliant manner; invoicing to manufacturers is done in accordance with contractual terms and according to CMS policies; and reconciling rebate payments from manufacturers and calculating payment invoices to health plans. All job duties and responsibilities must be carried out in compliance with applicable legal and regulatory requirements.

Essential Functions

-  Manages the Medicaid rebate operations team to ensure that program administration processes and procedures are efficient, effective and in compliance with all contractual obligations. This includes providing support during rebate client contract negotiations; conducting periodic reviews of documents such as contracts, payment reconciliations, invoices and utilization data to ensure accuracy and completeness and maximize top-line revenue potential for the client. Oversees the preparation of quarter end utilization submission packages to the clients for over 50 programs.
-  Coordinates the eRebate on-going with the help of the supervisors to ensure that each client is presented with a single point of contact to address any issues or concerns. Identifies on-going staff training and development opportunities to support continuous improvement and exceptional customer service.
-  Oversees the development, implementation and migration  efforts by providing specifications to ensure that it meets current needs of client base, consistent with strategic goals. Works with company?s IT Administration, third-party developer, and company management to drive development and utilization of the eRebate system to ensure necessary changes are implemented at the best cost and time. Working with the Account Management and Trade Relations teams, ensures mission critical reporting and business intelligence is being developed and delivered in eRebate.
-  Responsible for implementation and maintenance of processes to streamline the data flow. Serves as point of contact to internal departments of the company, including participating in internal and external audits.
-  Participates and leads (as appropriate) in the development of internal and external analytical tools to better manage rebate operations and support the client. Contributes to the RFP process as well as attending perspective client presentations when necessary.


General Job Information


Director, Pharmacy Rebate Operations



Job Family

Finance Group


United States of America

FLSA Status

United States of America (Exempt)

Recruiting Start Date


Date Requisition Created


Minimum Qualifications


Bachelors: Business Administration (Required), Bachelors: Finance (Required), Masters

License and Certifications - Required

License and Certifications - Preferred

Other Job Requirements


Experience in highly analytical environment. Knowledge of healthcare and PBM data. Ability to lead and manage others in a team environment. Technical proficiency and understanding of relational databases (Oracle, SQL Server and MS Access) and large data structures. Proficient in MS Excel. Ability to translate data into clear and meaningful reports. Ability to implement methods to assess accuracy of data extraction and data manipulation process. Excellent verbal and written communication skills. Ability to establish relationships with new health plan clients and pharmaceutical manufacturer partners as well as nurture relationships with existing clients/manufacturers.Prior experience in Data Analytics, Health Plan Payor, or PBM required.Experience interacting with clients or sales prospects.

Magellan Health Services is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled

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