Director, Medicaid Rebate Operations – Implementations

This is a fully remote position, open to applicants in Arizona.

📋 Description

• Provides executive leadership for the comprehensive delivery of drug rebate solutions, encompassing new client implementations and ongoing rebate operations.

• Manages an organization of around 100 professionals across implementation, technical support, operations, and analytics.

• Offers strategic and day-to-day leadership for the implementation and operations teams.

• Establishes goals and performance standards, mentors managers and supervisors, and fosters a culture of accountability, quality, and continuous improvement.

• Oversees the entire implementation lifecycle, which includes requirements gathering, system configuration, data conversion, testing, go-live, and transition to operations.

• Directs rebate operations, including invoicing, collections, dispute resolution, and reconciliation.

• Provides technical leadership for rebate platforms, data feeds, and system enhancements.

• Collaborates with IT, product, and data teams to prioritize requirements, promote automation, and enhance data integrity, controls, and audit readiness.

• Advises client executives by analyzing and communicating rebate performance, accounts receivable and aging, dispute trends, and forecasts.

• Monitors and guides clients on federal and state program requirements, supplemental rebate agreements, third-party liability, 340B, and CMS initiatives.

• Develops and manages operating budgets, staffing models, and resource plans.

• Defines and tracks key performance metrics and service level agreements, providing results through dashboards and quarterly business reviews.

• Builds and sustains strategic relationships with state agency leaders and client account teams.

• Manages escalations and represents the organization in client meetings, audits, and RFP responses.

• Drives process improvement, standardization, and automation initiatives.

• Ensures compliance with contractual, regulatory, and security requirements, collaborating with compliance, legal, finance, and cross-functional leaders.

⛳️ Requirements

• A minimum of ten years of experience in Medicaid drug rebate.

• A Bachelor's degree in business, finance, health care administration, information systems, or a related field, or an equivalent combination of education and experience.

• A Master's degree is preferred.

• Proven experience in a supervisory or management role, including leading large teams.

• Demonstrated success in leading client implementations and managing complex, multi-phase projects from kickoff through go-live and steady-state operations.

• Strong technical expertise with rebate and claims systems, data structures, reporting and analytics tools, and process automation.

• Ability to work effectively with IT and engineering teams.

• Strong financial acumen, with experience analyzing rebate performance, accounts receivable, and forecasting, alongside presenting financial results to executive audiences.

• Working knowledge of Medicaid and pharmacy programs and regulations impacting rebates, such as CMS requirements, state plan amendments, supplemental rebates, 340B, third-party liability, and unit rebate amount calculations.

• Proven track record of managing client relationships at the executive level, including contract performance, service level management, and issue escalation.

• Exceptional written and verbal communication skills, capable of clearly explaining technical and financial concepts to both technical and non-technical audiences.

• A history of developing leaders, managing change, and driving measurable operational improvements.

🏝️ Benefits

• Flexible work arrangements.

• Opportunities for learning and career advancement.

• Generous and flexible vacation policy.

• 401(k) employer matching.

• Comprehensive health benefits.

• Educational assistance.

• Leadership and technical development academies.