This position is responsible for providing backup support to the supervisor with the ability to independently resolve escalated issues. Maintains consistent high-quality performance. Trains and leads team members. Provides assistance to supervisor in all aspects other than personnel related activities.
Support the Rebate Supervisor(s) to oversee day-to-day rebate operations, providing work assignments to ensure contractual SLAs are being met.
Serves as secondary point of contact for all escalations when Supervisor is unavailable.
Understands and adheres to departmental policies and procedures.
Leads new hire and refresher training to team members.
Provides procedural and/or system demonstrations, as needed.
Maintains a clear understanding of rebate client contractual requirements ensuring compliance with service level agreements.
Performs quarterly manufacturer rebate invoicing for assigned clients or manufacturers.
Creates and maintains invoicing practices, including pre-invoicing quality reviews and adjustments for fee for service, managed care, diabetic supply and supplemental rebate programs.
Produces reports, including federal rebate 64.9R.
Works directly with manufacturers pertaining to dispute resolution.
Serves as primary contact for manufacturers to answer/resolve rebate questions.
Conducts quality validation and approval of claim files.
Provides subject matter expertise for internal and external audits providing requested information and support.
Assists with payment posting and Dunning letter (late notice) management.
Assists Account Management with client requests.
Identifies areas of improvement and shares with leadership.
Mentors Billing Specialists and acts as resource for Q&A.
Assists with application updates and testing.
Attends meetings and conference calls with clients and drug manufacturers.
Provides training and participates in interviews/hiring process as needed.
Other Job Requirements
Responsibilities
7+ years of experience in customer support, analysis or business preferably within a financial environment.Bachelor's degree required or an additional 4 years of relevant experience in lieu of degree.Possesses progressive experience as a rebate specialist.Demonstrates master/expert skills in research and analysis.Proven leadership skills.Strong verbal and written communication skills.Strong working knowledge of Microsoft Word and Excel.
General Job Information
Title
Lead, Pharmacy Rebate Specialist, Medi-Cal
Grade
21
Work Experience - Required
Customer Service, Data Analysis, Operations
Work Experience - Preferred
Education - Required
A Combination of Education and Work Experience May Be Considered., Bachelors
Education - Preferred
License and Certifications - Required
License and Certifications - Preferred
CPT - Certified Pharmacy Technician - Pharmacy
Magellan Health, Inc. is proud to be an Equal Opportunity Employer and a Tobacco-free workplace. EOE/M/F/Vet/Disabled.Every employee must understand, comply with and attest to the security responsibilities and security controls unique to their position; and comply with all applicable legal, regulatory, and contractual requirements and internal policies and procedures.
Magellan is the employer of choice for hard working people interested in making a difference in the health care industry and in the communities where we work and live. Our strong culture of caring is the common thread in both our business strategy and our work environment. We value professional growth and development, total health and wellness, rewards and recognition as well as employee unity. Magellan is a place where you can thrive.
Magellan is committed to providing equal employment opportunities to employees and applicants for employment without regard to race, color, creed, religion, sex, gender identity and expression, sexual orientation, marital status, age, national origin, ancestry, citizenship, physical or mental disability, disabled veteran or veteran of the Vietnam Era status, or any other factors protected by law.
Magellan is committed to meeting applicable Federal labor and employment law posting requirements by providing necessary posters in a format which is easily accessible and conspicuous to all applicants. Copies of applicable posters are accessible by clicking here (https://www.magellanhealth.com/media/760295/mg-federal-contractors-applicant-english.pdf) .
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Please know that Magellan Health does not interview any candidate through email, nor do we issue checks to candidates to set up home offices. All of our available positions are posted on legitimate job boards and our recruitment team directly contacts candidates should there be a fit.
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