Pharmacy Rebate Program Director

Elevance Health•Wallingford, CA

19h•Hybrid

About The Position

The Pharmacy Rebate Program Director is responsible for leading end-to-end operational execution, reporting, auditing, and financial oversight of medical drug rebate programs, including invoicing, collections, and allocation of rebate dollars. This director plays a critical part in ensuring contract alignment, maximizing rebate revenue, and partnering cross-functionally with finance and external pharmaceutical manufacturers to resolve discrepancies and identify new revenue opportunities. CarelonRx pairs a strong, clinical-first lens with deep pharmacy expertise to create solutions that improve outcomes, control costs, and enhance each member’s health. This role requires associates to be in-office 3 days per week, fostering collaboration and connectivity, while providing flexibility to support productivity and work-life balance. This approach combines structured office engagement with the autonomy of virtual work, promoting a dynamic and adaptable workplace. Alternate locations may be considered if candidates reside within a commuting distance from an office. Candidates not within a reasonable commuting distance from the posting location(s) will not be considered for employment, unless an accommodation is granted as required by law. CarelonRx is a proud member of the Elevance Health family of companies.

Requirements

Requires a BA/BS in Business Administration, Finance, or related field and a minimum of 5 years of experience in the rebate field and Pharmacy Benefit Manager (PBM); or any combination of education and experience, which would provide an equivalent background.

Nice To Haves

Direct experience supporting medical drug rebate programs (buy-and-bill / medical benefit), including operations, contracting, invoicing, collections, and reconciliation processes is preferred.
Strong analytical expertise with demonstrated ability to analyze large, complex claims datasets, perform variance analysis, and identify revenue opportunities is preferred.
Experience working with pharmaceutical manufacturers to resolve rebate discrepancies and ensure contract alignment and collections accuracy is highly preferred.
Intermediate to advanced proficiency in Excel and/or data tools (e.g., Access) for large-scale data manipulation and reporting is preferred.
Background in health plans, PBM, or pharmaceutical manufacturers with understanding of rebate contract structures and eligibility considerations (e.g., exclusions such as 340B) is preferred.

Responsibilities

Ensures rebate and discount contract terms are accurately translated into system configurations, validating completeness and alignment with contractual requirements prior to invoicing.
Manages quarterly rebate invoicing processes, including validating data loads, executing invoice generation, and ensuring accuracy across large, complex datasets.
Manages rebate collections and reconciliation activities, ensuring payments received are accurate, properly allocated to claim-level detail, and aligned with contract expectations.
Investigates and resolves discrepancies by partnering directly with pharmaceutical manufacturers and internal stakeholders to drive timely resolution and optimize collection rates.
Performs detailed financial and claims-level data analysis to identify revenue leakage, variance drivers, and new rebate or contracting opportunities.
Functions as a key liaison across rebate operations, finance, and other corporate teams to support reporting, data feeds, and audit readiness.
Supports internal and external audit activities by providing documentation, data validation, and subject matter expertise on rebate operations and processes.