1+ months

Manager, Medicaid Claims & Contract Administration

Parsippany, NJ 07054
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Company Info

Teva is a global pharmaceutical leader and the world's largest generic medicines producer, committed to improving health and increasing access to quality health solutions worldwide. Our employees are at the core of our success, with colleagues in over 80 countries delivering the world's largest medicine cabinet to 200 million people every day. We offer a uniquely diverse portfolio of products and solutions for patients and we've built a promising pipeline centered around our core therapeutic areas. We are continually developing patient-centric solutions and significantly growing both our generic and specialty medicines business through investment in research and development, marketing, business development and innovation. This is how we improve health and enable people to live better, healthier lives. Join us on our journey of growth!

Job Description

The Manager of Medicaid Claims & Contract Administration will manage operations to provide prompt, accurate and compliant processing/payment of Medicaid rebates to our customers. Ensure that each assigned customer rebate program adheres to all CMS and other applicable requirements. This position also ensures that State federal and supplemental rebate programs are actively monitored. Ensure training for internal Medicaid analysts are accomplished, and the accurate publishing of documentation of communications addressing any changes in guidance for the Medicaid program that will impact to other internal operations. This position is responsible to provide first level approval, as required by SOX, of all outbound claim documents for accuracy (dollars & coding) and completeness. This position also provides key role in supporting of rebate/cash forecasting, government reporting, process improvement, system upgrade/implementation and ad hoc analysis and reports.

Essential Duties & Responsibilities

  • Review and approv high volume claism to ensure accuracy and completeness; minimize revenue leakage and reduce interest in a tight timeframe.
  • Provide guidance to staff in resolution of disputes with states. Escalate material unresolved issues to Director or Senior Manager
  • Setup new programs/contracts and perform system maintenance in Model N/Flex systems. Validate and approve contract updates for federal, state, & supplemental rebate programs.
  • Assist in performing quarterly pricing activities to include updates and entries in Medicaid Processing systems for all Customers.
  • Work independently with Finance on dispute report totals.
  • Stay on top of CMS Medicaid rule changes. Establish and maintain policies, procedures, and stanadards for Medicaid Rebate Processing in support of SOX, internal/external financial reporting, and government regulations.
  • Assist with special projects, system implementation and Ad hoc reports. Hire, coach, mentor, train, and retain a high performing staff.
Qualifications

Requirements:

 

  • High School diploma and/or GED is required
  • 5+ years of Medicaid Claim processing experience with a Pharmaceutical company, state and/or state agency or as a Medicaid consultant, required
  • Supervisory experience is required
  • Intermediate to advanced knowledge of the Model N or Revitas/Flex Medicaid and/or Flex Validata system (or other comparable system), and advanced Microsoft Excel skills
  • Familiarity with CMS Medicaid rules and state specific issues. Up to date knowledge on Medicaid Validation rules and issues with 340B covered entities
  • SAP, Business Intelligence, and Tableau reporting is preferred
  • Bachelor's Degree, MS or MBA highly preferred
Already Working @TEVA?

If you are a current Teva employee, please apply using the internal career site available on "Employee Central". By doing so, your application will be treated with priority. You will also be able to see opportunities that are open exclusively to Teva employees. Use the following link to search and apply: Internal Career Site

The internal career site is available from your home network as well. If you have trouble accessing your EC account, please contact your local HR/IT partner.

Posted: 2020-11-24 Expires: 2021-02-18

Join us at the forefront of pharmaceutical research and production. With state-of-the-art facilities, highly skilled colleagues, and a high-powered organizational culture, Teva offers you countless possibilities to make a real difference in people's lives and add value to your career.

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Manager, Medicaid Claims & Contract Administration

Teva Pharmaceuticals
Parsippany, NJ 07054

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