Project Manager
1 month ago
About Us
At Kalderos, we are building unifying technologies that bring transparency, trust, and equity to the entire healthcare community with a focus on pharmaceutical pricing. We eliminate waste in drug pricing, enabling innovation and patient access to novel and affordable therapies to improve health. Our success is measured when we can empower all of healthcare to focus more on improving the health of people.
That success is driven by Kalderos' greatest asset, our people. Our team thrives on the problems that we solve, is driven to innovate, and thrives on the feedback of their peers. Our team is passionate about what they do and we are looking for people to join our company and our mission.
That's where you come in We're looking for a knowledgeable and dedicated Project Manager to liaise with our pharmaceutical manufacturer customers and help us overdeliver on the services we offer to our clients.
What You'll Do:
- Claims Processing: Assist with the processing of Kalderos disputes, including managing assigned states end-to-end by entering claims into Medicaid claims adjudication systems, adjudicating claims, generating ROSI/PQAS, and performing data reconciliations with the states, including non-compliant claims identified by Kalderos
- Medicaid Disputes Support: Following the resolution of Kalderos' disputes with the states, enter the revised payable units to generate the relevant CMS-304a Prior Quarter Adjustment Statements ("PQAS") for payment processing
- Claims Management/Review: Review claims that are adjudicated by Medicaid rebate analysts
- Reporting: Provide insight with in-depth analytics and reporting to internal and external parties
- Training: Identify opportunities to incorporate Medicaid best practices from a process perspective and provide ongoing training/ reinforcement to team members
- Internal Coordination: Collaborate with and participate in a regular cadence of status check-ins with Kalderos' Customer Success and our customers
- Cultivate, develop, and maintain productive and valuable working relationships with State Medicaid personnel and other key stakeholders
- Provide subject expertise and operational support for federal, state & supplemental rebate programs
What You'll Bring:
- Manager-level experience with Medicaid
- Customer service/claims processing experience
- Outstanding attention to detail and adaptability to deliver world class results across a complex network of partners, providers and stakeholders
- Ability to identify areas for process and systems innovation and implement change that will enhance the overall effectiveness of the team
- Strong mathematical and analytical skills, along with demonstrated ability to prioritize multiple tasks simultaneously while meeting deadlines
- Advanced Microsoft Office and Google Suite skills
- Must be able to work in a collaborative team environment
- Must be able to present complex information clearly and with confidence
- Excellent written and verbal communication skills, capable of effectively interfacing with all levels in the company and also with external stakeholders
- Demonstrated proficiency in and specific knowledge and experience within US healthcare industry, Federal and State Government program administration (Medicare, Medicaid, 340B, Orphan Drug, etc), and managed healthcare in US
- Prior experience in SAP Vistex, Model N or other contract administration tool supporting rebates in US Healthcare industry highly preferably
This is a hybrid position based in Chicago, IL, Newark, NJ, or Boston, MA. The position will require 25-30% travel.
___________________________________________Highlighted Company Perks and Benefits
- Medical, Dental, and Vision benefits
- 401k with company match
- Flexible PTO with a 10 day minimum
- Opportunity for growth
- Mobile & Wifi Reimbursement
- Commuter Reimbursement
- Continuing education reimbursement
- Donation matching for charitable contributions
- Travel reimbursement for healthcare services not available near your home
- New employee home office setup reimbursement
What It's Like Working Here
- We thrive on collaboration, because we believe that all voices matter and we can only put our best work into the world when we work together to solve problems.
- We empower each other and believe in ensuring all voices are heard.
- We know the importance of feedback in individual and organizational growth and development, which is why we've embedded it into our practice and culture.
- We're curious and go deep. Our slack channel is filled throughout the day with insightful articles, discussions around our industry, healthcare, and our book club is always bursting with questions.
To learn more:
We know that job postings can be intimidating, and research shows that while men apply to jobs when they meet an average of 60% of the criteria, women and other marginalized folks tend to only apply when they check every box. We encourage you to apply if you think you may be a fit and give us both a chance to find out
Kalderos is proud to be an equal opportunity workplace. We are committed to equal opportunity regardless of race, color, religion, sex, national origin, sexual orientation, age, citizenship, marital status, disability, or veteran status.
Kalderos participates in E-Verify.
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