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Lead, Pharmacy Rebate Specialist, Medi-Cal

Company: Magellan Health
Location: Rancho Cordova
Posted on: June 13, 2022

Job Description:

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 Responsibilities7+ 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 TitleLead, Pharmacy Rebate Specialist, Medi-Cal Grade21 Work Experience - RequiredCustomer Service, Data Analysis, Operations Work Experience - Preferred Education - RequiredA Combination of Education and Work Experience May Be Considered., Bachelors Education - PreferredLicense and Certifications - RequiredLicense and Certifications - PreferredCPT - 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.

Keywords: Magellan Health, Rancho Cordova , Lead, Pharmacy Rebate Specialist, Medi-Cal, Healthcare , Rancho Cordova, California

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