What are the responsibilities and job description for the Pharmacy Benefits Management Consultant position at CoSourcing Partners?
Pharmacy Benefits Management Consultant
Rebate Functional Expert
We are seeking a highly experienced consultant with proven expertise in pharmacy rebates to oversee and advise on rebate operations within our Pharmacy Benefits Management (PBM) team. This role requires an in-depth understanding of rebate programs, Medicaid Drug Rebate Program (MDRP) compliance, and industry trends. The ideal candidate will have a strong background in rebate management, process improvement, and operational oversight to ensure efficiency, compliance, and optimal rebate financial performance.
Key Responsibilities:
Rebate Operations Consulting & Oversight:
- Provide expert guidance on day-to-day rebate operations, ensuring compliance with federal, state, and contractual requirements.
- Advise on team coordination to drive efficiency, accuracy, and performance in rebate processing.
- Identify opportunities for process optimization and automation within the rebate system.
- Serve as an escalation point for rebate-related challenges, collaborating with leadership to implement solutions.
Compliance & Audit Support:
- Ensure adherence to Medicaid Drug Rebate Program (MDRP), OIG, CMS, and state Medicaid contracts.
- Oversee rebate record management to meet regulatory and audit requirements.
- Coordinate with external auditors for SOC-1 audits and fulfill OIG and CMS audit requests.
- Collaborate with IT and compliance teams to implement necessary system changes for ongoing compliance.
Technology & Process Improvement:
- Serve as a strategic advisor between IT and Operations, managing system enhancements and troubleshooting issues.
- Support improvements in Cognos reporting, ensuring accuracy and efficiency in rebate analytics.
- Provide recommendations for modernized training techniques to enhance team competency and performance.
- Lead workflow efficiency projects, working closely with quality and training specialists.
Stakeholder & Client Engagement:
- Act as a subject matter expert (SME) on rebate operations, providing strategic insight into rebate trends and best practices.
- Partner with external manufacturers, Medicaid clients, and internal stakeholders to enhance rebate performance.
- Assist the Rebate Director in RFP processes, client-facing meetings, and business growth initiatives.
- Serve as the primary point of contact for manufacturer eInvoice operations, including registration, updates, and issue resolution.
Qualifications & Experience:
Required:
- Extensive knowledge of pharmacy rebates, CMS regulations, and Medicaid Drug Rebate Program (MDRP).
- 3 years of experience in rebate, PBM, or pharmacy-related environments, with a strong understanding of rebate operations.
- Proven ability to analyze and optimize workflows, processes, and compliance metrics in a high-volume operational setting.
- Strong experience in accounts receivable, collections, and rebate processing.
- Proficiency in Microsoft Office Suite (Excel), Cognos reporting, and rebate tracking systems.
- Experience in process improvement and automation within rebate management.
Preferred:
- Retail pharmacy, pharmacy tech, or PBM experience.
- Background in accounting or finance with an understanding of rebate financials.
- Experience in operations management, compliance, and auditing in a healthcare setting.
- Bachelor’s degree in Accounting, Finance, Business, or a related field (or equivalent experience).
Why Join Us?
This is an exciting opportunity for a rebate expert consultant to provide strategic guidance, drive efficiency, and contribute to the financial success of a growing PBM organization. If you thrive in a fast-paced, compliance-driven environment and have a passion for optimizing rebate strategies, we encourage you to apply!
At our organization, you’ll have the opportunity to work on impactful projects that redefine business operations. We foster a collaborative and innovative culture where your ideas and expertise will make a real difference.
Take the lead in shaping the future of intelligent automation. Apply now and be a key part of our journey toward operational excellence!
CoSourcing Partners is an equal opportunity employer committed to fostering an inclusive and diverse workplace. We do not discriminate based on race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, veteran status, genetic information, or any other protected status under applicable federal, state, or local laws.
We believe in creating a work environment where all employees feel valued, respected, and empowered to contribute to our success. Accommodations are available upon request for applicants with disabilities throughout the hiring process.
Join us and be part of a team that values diversity, equity, and inclusion.