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Lead, Pharmacy Rebate Specialist, Medi-Cal

Company: Magellan Health
Location: Rancho Cordova
Posted on: September 15, 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-CalGrade21 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 - PharmacySalary RangeSalary Minimum:$45,655Salary Maximum:$68,485 This information reflects the anticipated base salary range for this position based on current national data. Minimums and maximums may vary based on location. Actual pay will be adjusted based on an individual's skills, experience, education, and other job-related factors permitted by law. This position may be eligible for short-term incentives as well as a comprehensive benefits package. Magellan offers a broad range of health, life, voluntary and other benefits and perks that enhance your physical, mental, emotional and financial wellbeing. 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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