Analyst, Managed Care Rebate Operations

Summary:

This role is responsible for contract administration, data validation, analysis, processing and payment of rebates associated with Managed Care contracts. Primary duties include interpretation and evaluation of contract terms, claims eligibility validation, formulary verification, rebate adjudication and external customer management to ensure proper determination and payment of contracted rebates.

Responsibilities:

• Review executed paper contract, develop summary of contract terms and set up contract to accurately reflect the intent of the contract.
• Maintain Managed Care rebate contracts including contract terms, membership and formulary status
• Review and validate submitted Managed Care rebate claims data and make decisions on claims eligibility based on plan formulary status and compliance. Calculate rebates on eligible claims, review for accuracy through the thorough analysis and resolution of discrepancies and make decision on final payment due to customer per contract terms.
• Collaborate with Contract Operations team, as needed, to ensure that the intent of the contract is carried out in the rebate calculations and payments.
• Provide analytical thinking and business acumen to identify and make decisions to resolve variances in claims data trends or expected rebate rates. Evaluate invoices for year-to-date rebate payment trends and provide explanations for variances vs. prior periods. Make decisions to escalate certain unexplained variances which may indicate potential compliance or performance issues to leadership for further action.
• Prepare payment packages and process payments. Resolve outstanding issues to ensure payments are made within the contractual timeframe.
• Monitor drug formulary compliance.
• Serve as primary contact with external customers (payers) and Contract Operations team to address questions or to resolve issues. In the event of disputes, gather supporting facts and make recommendations for resolution for approval by management.
• Apply process oriented and critical thinking to enhance organizational effectiveness of accurate and timely contract administration and rebate processing. Revise SOPs as required to reflect process improvements.
• Maintain compliance with SOX and audit controls governing contract and rebate operations.
• Assist in fulfilling requirements related to internal/external audits of systems and processes, legal requests and government agency inquiries.

Qualifications:

• Minimum 2 years of experience in one of the following: contract administration, rebate processing or business/financial analysis
• Experience with analytical techniques to determine reasonableness of data, trends and the root cause of issues
• Demonstrated strong organizational skills
• Proven ability to multitask and make rapid decisions when discrepancies or non-routine situations arise
• Acquired effective communication skills and has dealt with both internal and external customers while obtaining the know-how to prompt them for complete/accurate information
• Flexible, team player open to collaborating across team assignments and ad-hoc projects
• MS Office (Excel, Access)
• Managed Care experience is preferred
• BA/BS degree is preferred

#LI-Hybrid

If you come across a role that intrigues you but doesn’t perfectly line up with your resume, we encourage you to apply anyway. You could be one step away from work that will transform your life and career.

Compensation Overview:

Madison - Giralda - NJ - US: $69,120 - $83,760 Princeton - NJ - US: $69,120 - $83,760

The starting compensation range(s) for this role are listed above for a full-time employee (FTE) basis. Additional incentive cash and stock opportunities (based on eligibility) may be available. The starting pay rate takes into account characteristics of the job, such as required skills, where the job is performed, the employee’s work schedule, job-related knowledge, and experience. Final, individual compensation will be decided based on demonstrated experience.

Eligibility for specific benefits listed on our careers site may vary based on the job and location. For more on benefits, please visit [ https://careers.bms.com/life-at-bms/.](https://careers.bms.com/life-at-bms/)

Benefit offerings are subject to the terms and conditions of the applicable plans in effect at the time and may require enrollment. Our benefits include:

• Health Coverage: Medical, pharmacy, dental, and vision care.
• Wellbeing Support: Programs such as BMS Well-Being Account, BMS Living Life Better, and Employee Assistance Programs (EAP).
• Financial Well-being and Protection: 401(k) plan, short- and long-term disability, life insurance, accident insurance, supplemental health insurance, business travel protection, personal liability protection, identity theft benefit, legal support, and survivor support.

​ Work-life benefits include:

Paid Time Off

• US Exempt Employees: flexible time off (unlimited, with manager approval, 11 paid national holidays (not applicable to employees in Phoenix, AZ, Puerto Rico or Rayzebio employees)
• Phoenix, AZ, Puerto Rico and Rayzebio Exempt, Non-Exempt, Hourly Employees: 160 hours annual paid vacation for new hires with manager approval, 11 national holidays, and 3 optional holidays

Based on eligibility*, additional time off for employees may include unlimited paid sick time, up to 2 paid volunteer days per year, summer hours flexibility, leaves of absence for medical, personal, parental, caregiver, bereavement, and military needs and an annual Global Shutdown between Christmas and New Years Day.

All global employees full and part-time who are actively employed at and paid directly by BMS at the end of the calendar year are eligible to take advantage of the Global Shutdown.

***Eligibility Disclosure:T_ he summer hours program is for United States (U.S.) office-based employees due to the unique nature of their work. Summer hours are generally not available for field sales and manufacturing operations and may also be limited for the capability centers. Employees in remote-by-design or lab-based roles may be eligible for summer hours, depending on the nature of their work, and should discuss eligibility with their manager. Employees covered under a collective bargaining agreement should consult that document to determine if they are eligible. Contractors, leased workers and other service providers are not eligible to participate in the program.

On-site Protocol

BMS has an occupancy structure that determines where an employee is required to conduct their work. This structure includes site-essential, site-by-design, field-based and remote-by-design jobs. The occupancy type that you are assigned is determined by the nature and responsibilities of your role:

Site-essential roles require 100% of shifts onsite at your assigned facility. Site-by-design roles may be eligible for a hybrid work model with at least 50% onsite at your assigned facility. For these roles, onsite presence is considered an essential job function and is critical to collaboration, innovation, productivity, and a positive Company culture. For field-based and remote-by-design roles the ability to physically travel to visit customers, patients or business partners and to attend meetings on behalf of BMS as directed is an essential job function.

Supporting People with Disabilities

BMS is dedicated to ensuring that people with disabilities can excel through a transparent recruitment process, reasonable workplace accommodations/adjustments and ongoing support in their roles. Applicants can request a reasonable workplace accommodation/adjustment prior to accepting a job offer. If you require reasonable accommodations/adjustments in completing this application, or in any part of the recruitment process, direct your inquiries to adastaffingsupport@bms.com. Visit [careers.bms.com/](https://careers.bms.com/eeo-accessibility)[eeo](https://careers.bms.com/eeo-accessibility)[-accessibility](https://careers.bms.com/eeo-accessibility) to access our complete Equal Employment Opportunity statement.

Candidate Rights

BMS will consider for employment qualified applicants with arrest and conviction records, pursuant to applicable laws in your area.

If you live in or expect to work from Los Angeles County if hired for this position, please visit this page for important additional information: [https://careers.bms.com/california-residents/](https://careers.bms.com/california-residents/)

Data Protection

We will never request payments, financial information, or social security numbers during our application or recruitment process. Learn more about protecting yourself at [https://careers.bms.com/fraud-protection](http://careers.bms.com/fraud-protection).

Any data processed in connection with role applications will be treated in accordance with applicable data privacy policies and regulations.

If you believe that the job posting is missing information required by local law or incorrect in any way, please contact BMS at TAEnablement@bms.com. Please provide the Job Title and Requisition number so we can review. Communications related to your your application should not be sent to this email and you will not receive a response. Inquiries related to the status of your application should be directed to Chat with Ripley.