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Managed Care Rebate Analyst/Consultant

2 months ago

Parsippany, United States Cognizant Full time

About Us:
Cognizant (Nasdaq: CTSH) engineers’ modern businesses. We help our clients modernize technology, reimagine processes and transform experiences so they can stay ahead in our fast-changing world. Together, we're improving everyday life. See how at www.cognizant.com
The role is encouraged to drive technology discussions and analyze the current landscape for gaps in addressing business needs. Cognizant needs a motivated individual to challenge the status quo and provide thought leadership/standard methodologies to improve our current services and technologies.

Role: Managed Care Rebate Analyst/Consultant (Must have experience in Model-N)

Job Summary
The ideal candidate will have expertise in Model N
The Managed Care Rebate Analyst/Consultant is responsible for the processing of Managed Care Commercial, Medicare Part D, Managed Medicaid, and Medical Agreement rebate claims in accordance with the terms and conditions of the rebate contract and internal processing procedures. This position is responsible for analyzing utilization data, applying rules to determine included and excluded claims, assigning appropriate rebate percentages to utilization claims, and initiating payment to customers within contractual guidelines.

• Must have a thorough understanding of PBM networks, drug formularies, and all Managed Care rebate and fee types, including Base Rebates, Administrative Fees, Price Inflation Rebates
• Interpret contract language; input/maintain plans, products, and reimbursement thresholds in the Model N/Flex System
• Analyzes utilization data for completeness and accuracy
• Applies appropriate validations to utilization data; exclude ineligible claims (duplicates, ineligible pharmacies, aberrant quantities)
• Processes rebates through Model N/Flex Revenue Manager Submissions, Adjudications and Settlement Modules, resolving all errors and rejecting lines where appropriate
• Ensures calculated reimbursements are approved at all levels and prepared for payment
• Tracks invoice and calculation amounts; analyzes and explains large variances period over period and invoice vs. calculated amounts
• Assists with system testing as needed
• Maintains and communicates payment calculation details and rejected claim explanation to management and/or customer

Experience and qualifications
• Must have extensive experience with Model N/Flex – Validate and Revenue Manager modules; Validating utilization data from PBMs, Managed Care Contract maintenance, and Managed Care Rebate Processing
• Intermediate Excel Level – extensive experience with pivot tables, vlookups
• Exemplary Analytical skills
• Minimum 2 years’ experience processing Managed Care Rebates •
• Minimum 2 years’ experience with Pharmaceutical Manufacturer.
• Thorough understanding of PBM networks and drug formularies
• Minimum 2 years’ experience with Model N/Flex, Legacy Model N, or Revitas
• Intermediate Excel Skills (pivot tables, vlookups)

Salary and Other Compensation:
The annual salary for this position is depending on experience and other qualifications of the successful candidate.
This position is also eligible for Cognizant’s discretionary annual incentive program, based on performance and subject to the terms of Cognizant’s applicable plans.

Benefits: Cognizant offers the following benefits for this position, subject to applicable eligibility requirements:
Medical/Dental/Vision/Life Insurance
Paid holidays plus Paid Time Off
401(k) plan and contributions
Long-term/Short-term Disability
Paid Parental Leave
Employee Stock Purchase Plan
Disclaimer: The salary, other compensation, and benefits information is accurate as of the date of this posting. Cognizant reserves the right to modify this information at any time, subject to applicable law.