Allergan Medicaid Analyst in Parsippany, New Jersey
Parsippany, New Jersey, United States at http://agn.referrals.selectminds.com/jobs/795/other-jobs-matching/location-only
Oct 06, 2016Post Date
Allergan plc (NYSE: AGN) is a bold, global pharmaceutical company and a leader in a new industry model – Growth Pharma. Allergan is focused on developing, manufacturing and commercializing branded pharmaceuticals and biologic products for patients around the world.
Allergan markets a portfolio of best-in-class products that provide novel treatments for the central nervous system, eye care, medical aesthetics and dermatology, gastroenterology, women's health, urology, anti-infective and cardiovascular therapeutic categories. With commercial operations in approximately 100 countries, Allergan is committed to working with physicians, healthcare providers and patients to deliver innovative and meaningful treatments that help people around the world live longer, healthier lives.
Our success is powered by our world-class team’s commitment to being Bold for Life. Together, we build bridges, power ideas, act fast and drive results for our customers and patients around the world by always doing what it is right.
Join one of the world’s fastest growing pharmaceutical companies!
At Allergan you will have the opportunity to thrive in a fast-paced, strategic environment where bold, innovative thinking isn’t just welcomed, it’s encouraged. Across all functions, we relish the opportunity to help our people fulfill their potential. Our rapid growth strategy means plenty of opportunities to step into the spotlight.
Responsible for the administration and analysis of State Medicaid contracts including reviewing and validating submissions, processing and paying rebates, and analyzing quarterly utilization and rebate trends and variances. Perform and analyze Medicaid calculations including Average Manufacturer’s Price (AMP), Best Price (BP), Medicaid Rebate Per Unit (RPU) and Coverage Gap payments. Manages responsibilities in accordance with various state & federal regulations including but not limited to: Section 1927 of the Social Security Act, the Omnibus Budget Reconciliation Act of 1990 and 1993, Section 602 of the Veterans Healthcare Act, and Sarbanes Oxley as well as internal policies and procedures.
. PRIMARY JOB RESPONSIBILITIES:
CONTRACT ADMINISTRATION/PROCESS REBATES: Review and analyze all contract fields and evaluate contract language to uphold integrity of Revitas system. Manage contract changes such as adding/deleting products. Review and analyze pricing in Revitas contract systems; ensure accurate reimbursement; maintain proper contract files; monitor contract expiration report. Analyzes Medicare Coverage Gap claim reports, research and make sound decisions to resolve issues and ensure timely communication to third parties. Process Medicaid Rebates and Coverage GAP Claims within the Revitas Medicaid Module for Federal Statutory Programs, State Supplemental, and State Pharmaceutical Assistance Programs (SPAPs). Resolve open disputes with states. Work closely with State personnel, internal customers, and finance and rebate teams. Maintain good customer relations.
SYSTEM MAINTENANCE: Load/maintain all products, pricing and contract information in the Revitas Medicaid Module; ensure proper set-up, coverage, calculation and reimbursement of all programs & products. Perform system preparation for each quarterly rebate cycle including but not limited to, RPU calculations, new product baseline data, T-Bill rates, CPI-U indexes, calculation methods, etc. Work with internal & external IT support teams on system issues, upgrades and patches. Review, analyze and resolve price discrepancies with Palmetto GBA, CMS and the states; follow-up and correct all issues related to processing claims or system issues.
REPORTS & ANALYSIS: Compile necessary reports needed to support pricing disclosures; document explanations in file. Compile & distribute quarterly and ad-hoc Coverage Gap, sales, trend, and rebate reports to internal and external customers. Use internal systems to compile data necessary to research specific price issues related to internal self-audit or government initiated audits.
. ADDITIONAL JOB RESPONSIBILITIES:
STANDARD OPERATING PROCEDURES: Update SOP's as changes in law, business, systems, or processes dictate. Ensure proper compliance with Sarbanes Oxley controls; submit reports necessary to audit tests.
FILE MAINTENANCE/DOCUMENTATION: Compile and maintain files for quarterly submissions, contracts, etc.
Experience: Minimum of 0-2 years’ work experience required, preferably in the pharmaceutical or financial industries.
Knowledge, Skills, and Abilities
Strong analytical, problem-solving and organizational skills
Proficiency in Microsoft Excel
Excellent analytical and organizational skills
Ability to manage multiple tasks, priorities and timelines
A self-starter who can work independently
Functional knowledge of Revitas and Medicaid systems preferred
Education: Bachelor’s Degree Finance/IT or minimum 1-3 years of experience processing Medicaid Rebates required.