Senior Manager, Revenue Management Services – Medicaid Operations

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

📋 Description

• Oversee the Medicaid Operations segment within Revenue Management Services

• Act as the Medicaid expert and leader in the field

• Develop and maintain exceptional service delivery processes and outcomes

• Enhance efficiency, process improvements, operational excellence, and changes

• Evaluate and endorse Medicaid rebate deliverables for quality, accuracy, compliance, and adherence to service level agreements (SLA)

• Assess and approve customer contract setups, maintenance, and data management in Model N systems

• Adhere to SOC controls and internal protocols

• Establish best practices for Medicaid processing and contracting, providing thought leadership

• Analyze regulatory changes and initiate necessary process and system modifications

• Inform internal and external stakeholders about regulatory impacts

• Promote rebate savings through detailed validations at the claims level and collaborate with states to address disputes

• Mentor, coach, and cultivate a high-performing Medicaid operations team

• Enhance team capabilities through goal setting, feedback, development planning, and performance management

• Foster an inclusive, globally connected team atmosphere

• Guide the team through evolving client needs, regulations, technologies, and priorities

• Cultivate and expand strategic client relationships and serve as the senior escalation contact

• Address client inquiries regarding processing status, reconciliations, data discrepancies, and payments

• Work in collaboration with GP Pricing and GTN teams

• Partner with product teams on system enhancements, AI, automation, requirements, testing, and change management

⛳️ Requirements

• Bachelor's degree in Accounting, Finance, Business, or a related discipline

• Over 10 years of experience in the pharmaceutical industry with Medicaid agreements, including team leadership and client relationship management

• Demonstrated experience in people leadership

• Proven ability to lead through changes and drive process improvements and operational transformations

• Familiarity with Medicaid rebate systems

• Recognized authority in Medicaid rebates

• Experience in environments with mandated deadlines and managing multiple client projects

• Capability to understand, retain, build upon, and apply intricate government compliance requirements

• High accuracy, attention to detail, and strong analytical skills

• Ability to juggle multiple competing tasks across various functional areas

• Technical proficiency in understanding underlying data structures and handling large data volumes

• Experience in achieving and maintaining regulatory, legal, and operational compliance

• Capability to deliver timely results accurately with minimal oversight

• Demonstrated experience utilizing generative AI tools such as ChatGPT, Copilot, Claude, or Gemini

• Advanced skills in Microsoft Office, particularly Excel, PowerPoint, and Word

• Willingness to travel 10-20%

🏝️ Benefits

• Unlimited paid time off (PTO) for salaried employees

• Comprehensive medical, dental, and vision insurance

• Health Savings and Flexible Spending Accounts

• 401(k) plan with company matching

• Volunteer Time Off (VTO)

• Life and pet insurance options

• Employee Assistance and Mental Health Programs

• Opportunities for charitable giving

• Professional coaching and career development support