Director – Rebate Contract Operations

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

📋 Description

• Facilitate data transfer between the Lumicera Contracts team and various internal stakeholders, including finance, analytics, sales, and account management.

• Oversee data exchange between Lumicera, GPO, and pharmaceutical companies or other vendors, including the submission of claims data.

• Collaborate with IT to prioritize and implement solutions that meet all data flow requirements.

• Receive and analyze Account Reconciliation files, providing necessary data for finance to invoice clients.

• Conduct audits as needed.

• Manage the onboarding of new clients, which includes evaluating formularies from a consolidated perspective.

• Perform prospective reporting, including forecasting and projecting rates based on current data, while documenting assumptions and caveats in the calculation of forecasted rates.

• Develop a potential bid grid based on known data components, while making and documenting necessary assumptions.

• Continuously compare actual outcomes against forecasts to refine assumptions.

• Forecast guarantees based on rates, utilization, and factors such as inflation.

• Conduct retrospective reporting to ensure timely and accurate generation of all client reports.

• Analyze data to confirm clients receive maximum value from contracts.

• Identify any gaps in contract performance and work with key stakeholders to address them.

• Optimize contracts by evaluating client formularies against the best formulary placements with pharmaceutical companies and GPOs, supplying necessary information to contractors for effective discussions aimed at maximizing client contracts while adhering to a low net cost philosophy.

• Ensure timely and accurate responses to RFPs.

• Develop guarantees using appropriate methodologies that account for risk.

• Maintain alignment with Implementations and Sales to ensure the conditions associated with guarantees are met.

• Understand client and regulatory requirements related to the service.

• Operationalize the service by closely collaborating with other operational areas such as formulary management and claims adjudication to ensure accurate setup.

• Work with vendors or strategic partners to ensure a mutually beneficial relationship, including aligning strategic objectives, tracking vendor performance against guarantees, managing dispute resolution processes, and creating comprehensive dashboards that reflect the current state.

• Perform other duties as assigned.

⛳️ Requirements

• A Bachelor’s degree or equivalent work experience is required.

• A minimum of 2 years of experience in a PBM, GPO, or comparable environment is required.

• Proven experience in designing operations, building processes, and scaling automation is required.

• A demonstrated history of process improvement and system enhancements is required.

• Familiarity with tools and systems for process automation is preferred.

• A proven ability to collaborate with multiple internal and external stakeholders is required.

• Leadership experience is required.

• Experience working with senior leadership within an organization is required.

• Active participation in, adherence to, and support of compliance program objectives is essential.

• Ability to interact cooperatively and respectfully with other employees consistently.

🏝️ Benefits

• Comprehensive benefits package for health, dental, and vision insurance.

• 20 days of paid time off.

• 4 weeks of paid parental leave.

• 9 paid holidays.

• 401K company match of up to 5% with no vesting requirement.

• Adoption Assistance Program.

• Flexible Spending Account.

• Educational Assistance Plan and support for professional memberships.

• Referral Bonus Program offering up to $750!