Sr. Analyst, Managed Care

Sr. Analyst, Managed Care United States - California - Foster City Market Access & Health Economics Regular Gilead Sciences Inc. is seeking a Sr. Rebates Analyst to take the lead in managing Gilead’s day-to-day administration and processing of all Managed Care Commercial/Medicare Part D contract payments, in support of the contract development activities of the Managed Markets Strategy & Operations group. This group is responsible for managing and supporting Gilead’s strategies with national and regional Managed Markets accounts in order to provide appropriate patient access to Gilead’s products.

This position has primary ownership of maintaining strong relationships with Payers and ensuring that all contract payments and associated reporting are completed on time and follow established policies and procedures. Function as a rebate data subject matter expert to ensure proper data validation, verification of contract compliance, rebate processing, and payment analysis to protect Gilead from revenue leakage.

Duties

and Responsibilities (included but not limited to): Create, drive, and analyze day to day operational reports and metrics to ensure adherence of contracts to expected service levels, identify / communicate program trends and support continuous improvement. Manage contracts into Gilead’s operational systems based on terms and conditions written in the agreements as well as making sure contractual obligations are accurately captured and updated. Work with external customers and internal stakeholders to resolve disputes in a timely manner and to Gilead’s advantage whenever practical. Use statistical methods to gather and analyze data, create reports and recommend potential adjustments based on variance analysis.

Function as a subject matter expert and technical resources on rebating systems/tools. Review and validate customer submissions within an appropriate timeframe to ensure data is accurate to allow Gilead to properly process and pay on time. Track all submissions and payments through Gilead systems (Sharepoint, Model N, Validata, OIMS) to proactively build in lead time to execute rebate payments. Work with management team to create a prioritized list of needs for each business segment, working to outline the specific data needs for each business method and analysis project.

Proactively research and analyze payment variances and trends, to find outliers and research root causes for potential upstream errors or market activity. Support the development and maintenance of policies and standard operating procedures to ensure compliance. Participate in internal and external audits, when needed, in order to demonstrate compliance with policies, laws, and regulations. Effectively interact with various key internal and external stakeholders (i.e.

Customers, Contract/Account managers, Strategy and Analytics, FP&A, A/P, legal, 3rd party consultants, etc.). Manage general customer service inquiries and supervise routing of questions to appropriate resources. Ability to manage and lead special projects as needed. Remain flexible and adaptive to changing business requirements and processes.

Work collaboratively with the team to accomplish departmental goals. Education and Experience Requirements: 3+ years of related experience in biotech, pharmaceutical, healthcare industry. Bachelor’s Degree required. Strong verbal, written, and interpersonal skills are required to ensure ability to interact with all levels of internal and external stakeholders.

Proven analytical experience and critical thinking skills are required. Proven ability to prioritize and manage rebate payment processing across channels and customers, including Commercial plans, Medicare Part D, Medicaid and Health Exchanges, with limited supervision to meet deadlines and exercise sound judgments in a fast‑paced environment. Invoice processing and customer service skills are required with an emphasis on time management, prompt follow‑through, and being proactive. Working knowledge of various claim processing principles, documentation requirements, and processing systems is required.

Basic knowledge of Model N and/or Validata is preferred but not required. Knowledge of health plans, PBMs, and pharmacy business is a plus. Data management skills and ability to analyze information to properly communicate relevant data to both internal and external stakeholders is required. Demonstrate decision‑making skills, ability to work collaboratively in a team structure, as well as ability to problem solve and troubleshoot issues by self with minimum guidance is required.

Effectively develop solutions to complex problems with minimal tools and guidance. Proficiency in Microsoft Excel and PowerPoint is required. Basic knowledge of Tableau or Alteryx is a plus. Demonstrate understanding and interpretation of contract language. #J-18808-Ljbffr