Senior Manager, Managed Care Rebate Integrity – Controls

🕒 Maio 6

🌽 Illinois – Remoto

🌽 Illinois – Remote

💵 $140.000 - $165.000 / ano

⏰ Tempo Integral

🟠 Sênior

👔 Gerente

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Fresenius Kabi USA

SiteLinkedInTodas as Vagas

1001 - 5000 funcionários

💊 Farmacêutico

🧬 Biotecnologia

🤝 B2B

Pharmaceuticals • Biotechnology • B2B

A Fresenius Kabi USA é uma empresa de saúde que desenvolve, fabrica e fornece medicamentos essenciais e tecnologias médicas para hospitais, centros de sangue e prestadores de serviços de saúde nos Estados Unidos. As ofertas da empresa incluem produtos farmacêuticos injetáveis, biofarmacêuticos, produtos de nutrição parenteral, sistemas de infusão e aférese, equipamentos de coleta e processamento de sangue e soluções de gerenciamento de dados para apoiar operações clínicas e de centros de sangue. A Fresenius Kabi USA foca em melhorar o acesso, a acessibilidade e a segurança das terapias, enquanto apoia o engajamento comunitário e a resiliência da cadeia de suprimentos.

Descrição

• Provide strategic oversight of pharmacy and medical rebate validation to protect revenue, ensure contractual compliance, and strengthen Gross-to-Net integrity. • Lead enterprise governance over data validation, dispute strategy, accrual accuracy, and vendor performance. • Drive analytics, automation, and systemic corrective actions to reduce financial leakage, improve recovery outcomes, and ensure audit-ready compliance across payer rebate programs. • Set enterprise validation strategy and own end-to-end rebate revenue integrity across pharmacy and medical benefit claims. • Establish and oversee data integrity governance for rebate submissions. • Lead contract operationalization and policy translation in partnership with Contracting/Legal. • Maintain strong understanding of PBM/MBM formulary structures, coverage criteria, benefit design changes. • Serve as subject matter expert on PBM/MBM formulary structures and benefits design changes. • Sponsor, Design & Lead payer rebate audit program.

🎯 Requisitos

• Bachelor’s degree in finance, Business, Analytics, Pharmacy Administration, Accounting, or related field. • 8+ years in pharma/biotech rebates, managed care operations, GTN, or contract/revenue integrity, with 2–4 years people leadership. • Strong understanding of PBM & MBM rebate programs, NCPDP data formats, formulary structures, and rebate contract terms. • Hands-on experience with rebate validation and disputes for PBM and medical benefit (e.g., J-code claims, buy-and-bill). • Experience working with or managing external vendors (e.g., IQVIA, Model N). • Strong analytical abilities and experience with large datasets (Excel, Power BI, Snowflake preferred).

🏖️ Benefícios

• medical, dental and vision coverage • life insurance • disability • 401K with company contribution • wellness program