Senior Rebate Audit Analyst
About The Position
As a Senior Rebate Audit Analyst, you will be vital to our success in achieving the mission of the Client Audit Department to provide best-in-industry audit management services to our internal and external business partners. In addition, you will help strive to ensure Optum Rx is only paying out on confirmed errors to reduce our financial liability and to ensure corrections are made in a timely manner. This position supports the facilitation of external audits focused on rebate administration (e.g., Rebate Minimum Guarantees, Rebate Billing/Collections, Rebate Credits). This role requires interaction with both internal business partners at various levels of the organization and the external audit community to successfully complete audits. Leveraging a well-established process, individuals in this role support our clients by responding to claim sets, audit reports, and generally being the liaison to the auditing entity.
Requirements
- High School Diploma/GED
- 3+ years of experience in PBM and/or Claims Audit experience
- 1+ years of Rebate Administration (e.g., Rebate Minimum Guarantees, Rebate Billing) experience
- Intermediate level of proficiency in project management
- Intermediate proficiency within Microsoft Office Suite (Excel, Word, PowerPoint). Must know how to use and apply formulas, filters, and sorting techniques in Excel
- Intermediate level of proficiency with written and verbal communications skills, including preparing, leading, and presenting in meetings with various levels of leadership on complex topics
- Ability to explain complex topics in a simplified manner for easy understanding
- Ability to change gears in a high paced, highly functional team
- Ability to Travel up to 10%25
Nice To Haves
- Bachelor’s degree
- Proven track record of effectively managing time, resources, and tasks to achieve hard deadlines
- Experience facilitating PBM audits; specifically, rebate administration audits
- Experience interpreting Rebate Minimum Guarantees in client contracts
- Ability to interpret pharmaceutical manufacturer rebate contract language (e.g., base rates, price protection, manufacture administration fees)
- Experience working in Rebate Billing Systems
- Experience working with upper leadership and presenting confidently on complex issues
- Experience leading projects lasting three months or longer
- Certified Pharmacy Technician
- Internal or Quality Auditing experience
Responsibilities
- Facilitate end-to-end management of external client audits focused mainly on rebate administration
- Support manufacturer billing rebate audits conducted virtually and, in some cases, physically on-site
- Request and obtain rebate documentation from internal teams to provide to external audit firms within established turn-around times
- Read and interpret client contracts, pharmaceutical rebate contracts, and rebate reporting
- Perform research to ensure claims were accounted for correctly in minimum rebate guarantee reconciliations
- Respond to claim sample inquiries and audit reports from external audit firms
- Actively participate on Department projects
- Consistently meet established productivity, deliverable timeline adherence, and Department quality standards
Benefits
- comprehensive benefits package
- incentive and recognition programs
- equity stock purchase
- 401k contribution
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What This Job Offers
Job Type
Full-time
Career Level
Senior
Education Level
High school or GED
