Analyst, Managed Care Rebate Operations

Main Location
New York City, NY, United States
Open jobs

At Bristol Myers Squibb, we are inspired by a single vision – transforming patients’ lives through science. In oncology, hematology, immunology and cardiovascular disease – and one of the most diverse and promising pipelines in the industry – each of our passionate colleagues contribute to innovations that drive meaningful change. We bring a human touch to every treatment we pioneer. Join us and make a difference.

Position 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. Location for the position Princeton Pike or Summit, New Jersey.

Operations Analyst 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 the contract terms
  • Collaborate with VAP 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 VAP 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 VAP Contract Operations team to address questions or to resolve issues. In the event of disputes, gather supporting facts and make recommendation for resolution for approval by VAP 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 experience in one of the following: contract administration, rebate processing or business/financial analysis
  • Has experience with analytical techniques to determine reasonableness of data, trends and the root cause of issues
  • Has demonstrated strong organizational skills
  • Has proven ability to multitask and make rapid decisions when discrepancies or non-routine situations arise
  • Has 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

Around the world, we are passionate about making an impact on the lives of patients with serious diseases. Empowered to apply our individual talents and diverse perspectives in an inclusive culture, our shared values of passion, innovation, urgency, accountability, inclusion and integrity bring out the highest potential of each of our colleagues.

Bristol Myers Squibb recognizes the importance of balance and flexibility in our work environment. We offer a wide variety of competitive benefits, services and programs that provide our employees with the resources to pursue their goals, both at work and in their personal lives.


Mission
We're a community of women leveraging our connections into top companies to help underrepresented women get the roles they've always deserved. Simultaneously, we work to build truly inclusive hiring processes and environments where women can thrive and not just survive.
Are you hiring? Join our platform for diversifiying your team
Analyst, Managed Care Rebate Operations
Bristol Myers Squibb