Senior Healthcare Rebate Analyst

2 weeks ago


Parsippany, New Jersey, United States Cynet Systems Full time
Job Overview

We are seeking a Senior Healthcare Rebate Analyst to join our team at Cynet Systems.

Position Title: Senior Healthcare Rebate Analyst

Location: Remote

Employment Type: Contract

Compensation: $35/hr - $40/hr

Key Responsibilities:
  • The Senior Healthcare Rebate Analyst will oversee the processing of rebate claims for Managed Care Commercial, Medicare Part D, Managed Medicaid, and Medical Agreements, ensuring compliance with rebate contracts and internal protocols.
  • This role involves analyzing utilization data, applying relevant rules to determine claim eligibility, assigning appropriate rebate percentages, and facilitating payments to clients in accordance with contractual obligations.
  • A comprehensive understanding of Pharmacy Benefit Manager (PBM) networks, drug formularies, and various Managed Care rebate types, including Base Rebates, Administrative Fees, and Price Inflation Rebates, is essential.
  • Interpret and manage contract language; input and maintain plans, products, and reimbursement thresholds within the Model N/Flex System.
  • Conduct thorough analyses of utilization data for accuracy and completeness.
  • Implement necessary validations on utilization data, excluding ineligible claims such as duplicates and aberrant quantities.
  • Process rebates through Model N/Flex Revenue Manager Submissions, Adjudications, and Settlement Modules, addressing errors and rejecting lines as necessary.
  • Ensure that calculated reimbursements receive approval at all levels and are prepared for payment.
  • Monitor invoice and calculation amounts; analyze and clarify significant variances between periods and between invoices and calculated amounts.
  • Assist with system testing as required.
  • Maintain clear communication regarding payment calculation details and rejected claims with management and/or clients.
Qualifications:
  • Extensive experience with Model N/Flex, including Validata and Revenue Manager modules; expertise in validating utilization data from PBMs, maintaining Managed Care Contracts, and processing Managed Care Rebates.
  • Intermediate proficiency in Excel, including extensive use of pivot tables and vlookups.
  • Exceptional analytical skills.
  • Strong communication abilities.
Core Competencies:
  • A minimum of 2 years of experience in processing Managed Care Rebates for Pharmaceutical Manufacturers.
  • Thorough knowledge of PBM networks and drug formularies.
  • Experience with all Managed Care rebate types, including Base Rebates, Administrative Fees, and Price Inflation Rebates.
  • A minimum of 2 years of experience with Model N/Flex, Legacy Model N, or Revitas.
  • Intermediate Excel skills (pivot tables, vlookups).
  • Strong analytical capabilities.
Company Overview

Visit our career site to explore all available positions at Cynet Systems.



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