Rebate Clinical Program Manager (PharmD)

MedImpact Healthcare Systems, Inc.•San Diego, CA

9d•$108,515 - $196,412•Onsite

About The Position

The Rebate Clinical Program Manager (CPM) optimizes the clinical quality and cost-effectiveness of drug rebate. Focuses on operational management of medical drug utilization by employing analytical tools. Works within an account team structure to achieve overall account and company financial goals. Relies on data and performance indicators, as well as experience and judgment, to identify and promote performance improvement opportunities which attain the aligned goals of Medlmpact and assigned clients.

Requirements

PharmD and 3+ years’ experience or equivalent combination of education and experience, and 1 year of SME in respective areas
Knowledge of Microsoft Office Suite
Working knowledge of relational databases
Registered Pharmacist
Analytical skills
Ability to solve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists.
Ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form. Ability to deal with problems involving several concrete variables in standardized situations.
Ability to apply concepts such as fractions, percentages, ratios, and proportions to practical situations.
Ability to work with mathematical concepts such as probability and statistical inference, and fundamentals of plane and solid geometry and trigonometry.
Ability to read, analyze, and interpret general business periodicals, professional journals, technical procedures, or governmental regulations.
Ability to write routine reports and correspondence.
Ability to speak effectively before groups of customers or employees of organization.
Composure
Decision Quality
Organizational Agility
Problem Solving
Customer Focus
Drive for Results
Peer Relations
Time Management
Dealing with Ambiguity
Learning on the Fly
Political Savvy
Regularly required to sit and talk or hear.
Regularly required to stand; walk; use hands to finger, handle, or feel and reach with hands and arms.
Occasionally lift and/or move up to 25 pounds.
Ability to maintain clear near visual acuity at approximately 20 inches or less (i.e., “close vision”) to accurately read fine print, view computer screens, and handle small objects.
Requires adequate color vision and depth perception to support safety and precision in detail-oriented tasks.

Nice To Haves

Health Informatics experience
Experience in promoting drug cost management programs

Responsibilities

Provides recommendations to assigned clients that align with both the clients' and Medlmpact's mutual goals. The strategic recommendations include: HCPCS/NDC analysis and suggestions, on-line rebate system edits and restrictions, and recommendations for accurate medical billing.
Provides clinical consultative services in accordance with CMS dispute resolution processes. The CM's focus will be centered on using a variety of analytical tools and clinical resources to identify opportunities which simultaneously improve the data integrity of the rebate program.
Performs provider audits and provider education for medical claim billing in regards to rebate processing.
Conducts claims analysis for incorrect, aberrant quantities billed for rebate invoicing.
Develops, maintains and recommends clinically appropriate unit of measure conversion for all NDC billing to CMS rebate units.
Other activities are centered on client specific requests and involve production of reports and providing financial and drug utilization data that assist the state(s) in determining their financial solvency, drug purchasing policies and allocation of received rebate monies.
Ensures timely and accurate review of claim data, according to policy, with appropriate intervention recommendations.
Supports 340B strategic initiatives.