Requisition ID 14372BR
Title Senior Associate - Government Contracts & Compliance
Job Category Finance
Job Description PURPOSE:
Processing and reconciling the Medicaid rebate claims utilizing the Model N Medicaid System. Prepared Medicaid analyses as required. Ensure NNI compliance with the Medicaid Drug Rebate Program (MDRP).
RELATIONSHIPS:
Internal interaction with both field and home office management. External interaction with Centers for Medicaid and Medicare Services(CMS), State Medicaid agencies, Pharmacy Benefit Administrators, and Veterans Administration/ Department of Defense.
ESSENTIAL FUNCTIONS:
• Assists internal & external customers with inquiries relating to Medicaid payments, dispute and contracts.
• Attends Financial Planning &Analysis (FP&A) forecasting meetings and provides guidance to FP&A Department on potential future Medicaid events that could impact rebate forecasting.
• Builds and maintains relationships with internal stakeholders to build an understanding of business objectives.
• Coordinates Medicaid claim data entry with third party vendors
• Coordinates Medicaid disputes with third party dispute vendor and provides periodic reporting to Sr. Management.
• Coordinates the implementation of Medicaid system enhancements and Medicaid system testing.
• Coordinates with Accounts Payable & IT regarding SAP interface check requests and wire transfers.
• Formats, reviews, processes and validates Medicaid rebate claims data.
• Prepares and distributes Medicaid rebate reports to field and home office.
• Prepares and reviews quarterly Medicaid, ADAP, SPAP and supplemental invoices and ensures compliance.
• Prepares Medicaid data analyses to explain variances between rebate periods.
• Reviews and analyzes data within Model N Medicaid system to ensure it reflects the contract terms.
• Reviews state data for reasonableness and issues payments.
• Stays up to date on Medicaid Rebate legislation.
• Submits disputes to dispute resolution consultant.
• Utilizes DNA Software for State Preferred Drug Lists and dispute analysis.
PHYSICAL REQUIREMENTS:
Not Applicable
DEVELOPMENT OF PEOPLE:
Not Applicable
KEY SUCCESS FACTORS: EDUCATION, EXPERIENCE, KNOWLEDGE AND SKILLS:
• Ability to interact with various departments and levels internally and externally.
• Ability to work independently.
• Advanced PC skills required.
• Bachelors degree preferred; relevant experience may be substituted for degree, when appropriate.
• Experience with Gov't Pricing Medicaid rebate system preferred (Model N, iMany).
• Intermediate level desirable in Access and Showcase Query.
• Intermediate level required in Excel.
• Knowledge of Medicaid Drug Rebate Program desirable.
• Requires a minimum of 3 years relevant experience.
• Strong analytical, quantitative, and qualitative analysis skills required.
• Strong attention to detail required.
Department FIN - GOVT CONTRACTS & COMPLIANCE (1)
Position Location US - Princeton, NJ
City Princeton
State/Provinces US - NJ
Degree Required Bachelor's Degree or equivalent experience
Percent Travel None
Title Senior Associate - Government Contracts & Compliance
Job Category Finance
Job Description PURPOSE:
Processing and reconciling the Medicaid rebate claims utilizing the Model N Medicaid System. Prepared Medicaid analyses as required. Ensure NNI compliance with the Medicaid Drug Rebate Program (MDRP).
RELATIONSHIPS:
Internal interaction with both field and home office management. External interaction with Centers for Medicaid and Medicare Services(CMS), State Medicaid agencies, Pharmacy Benefit Administrators, and Veterans Administration/ Department of Defense.
ESSENTIAL FUNCTIONS:
• Assists internal & external customers with inquiries relating to Medicaid payments, dispute and contracts.
• Attends Financial Planning &Analysis (FP&A) forecasting meetings and provides guidance to FP&A Department on potential future Medicaid events that could impact rebate forecasting.
• Builds and maintains relationships with internal stakeholders to build an understanding of business objectives.
• Coordinates Medicaid claim data entry with third party vendors
• Coordinates Medicaid disputes with third party dispute vendor and provides periodic reporting to Sr. Management.
• Coordinates the implementation of Medicaid system enhancements and Medicaid system testing.
• Coordinates with Accounts Payable & IT regarding SAP interface check requests and wire transfers.
• Formats, reviews, processes and validates Medicaid rebate claims data.
• Prepares and distributes Medicaid rebate reports to field and home office.
• Prepares and reviews quarterly Medicaid, ADAP, SPAP and supplemental invoices and ensures compliance.
• Prepares Medicaid data analyses to explain variances between rebate periods.
• Reviews and analyzes data within Model N Medicaid system to ensure it reflects the contract terms.
• Reviews state data for reasonableness and issues payments.
• Stays up to date on Medicaid Rebate legislation.
• Submits disputes to dispute resolution consultant.
• Utilizes DNA Software for State Preferred Drug Lists and dispute analysis.
PHYSICAL REQUIREMENTS:
Not Applicable
DEVELOPMENT OF PEOPLE:
Not Applicable
KEY SUCCESS FACTORS: EDUCATION, EXPERIENCE, KNOWLEDGE AND SKILLS:
• Ability to interact with various departments and levels internally and externally.
• Ability to work independently.
• Advanced PC skills required.
• Bachelors degree preferred; relevant experience may be substituted for degree, when appropriate.
• Experience with Gov't Pricing Medicaid rebate system preferred (Model N, iMany).
• Intermediate level desirable in Access and Showcase Query.
• Intermediate level required in Excel.
• Knowledge of Medicaid Drug Rebate Program desirable.
• Requires a minimum of 3 years relevant experience.
• Strong analytical, quantitative, and qualitative analysis skills required.
• Strong attention to detail required.
Department FIN - GOVT CONTRACTS & COMPLIANCE (1)
Position Location US - Princeton, NJ
City Princeton
State/Provinces US - NJ
Degree Required Bachelor's Degree or equivalent experience
Percent Travel None