Lead, Pharmacy Rebate Specialist, Medi-Cal

Company: Magellan Health
Location: Rancho Cordova
Posted on: June 19, 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 RequirementsResponsibilities7+ 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 InformationTitleLead, Pharmacy Rebate Specialist, Medi-CalGrade21Work Experience - RequiredCustomer Service, Data Analysis, OperationsWork Experience - PreferredEducation - RequiredA Combination of Education and Work Experience May Be Considered., BachelorsEducation - PreferredLicense and Certifications - RequiredLicense and Certifications - PreferredCPT - Certified Pharmacy Technician - PharmacyMagellan 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