Director, Medicaid Rebate Operations – Implementations

🔥 2 minutes ago

🌵 Arizona – Remote

🌵 Arizona – Remote

💵 $137.1k - $195.8k / year

⏰ Full Time

🔴 Lead

⚙️ Operations

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Gainwell Technologies

WebsiteLinkedInAll Job Openings

10,000+ employees

💼 Consulting

📦 Logistics

⚕️ Healthcare Insurance

💰 Grant on 2023-06

Consulting • Logistics • Healthcare Insurance

Gainwell Technologies is the nation’s leading provider of digital and cloud-enabled solutions across the human services and public health ecosystem. With a mission-driven approach, Gainwell serves clients in all 50 U. S. states, focusing on improving health outcomes and delivering intuitive, human-centered experiences. Their comprehensive suite of solutions includes Medicaid Enterprise modernization, data analytics, provider services, and pharmacy solutions, all designed to advance the future of healthcare and enhance community well-being.

📋 Description

• Provides executive leadership for the end-to-end delivery of drug rebate solutions, including new client implementations and ongoing rebate operations • Leads an organization of approximately 100 professionals across implementation, technical support, operations, and analytics • Provides strategic and day-to-day leadership for implementation and operations teams • Sets goals and performance standards, develops managers and supervisors, and builds a culture of accountability, quality, and continuous improvement • Oversees the full implementation lifecycle, including requirements gathering, system configuration, data conversion, testing, go-live, and transition to operations • Directs rebate operations, invoicing, collections, dispute resolution, and reconciliation • Provides technical leadership for rebate platforms, data feeds, and system enhancements • Partners with IT, product, and data teams to prioritize requirements, drive automation, and strengthen 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 advises 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, reporting results through dashboards and quarterly business reviews • Builds and maintains strategic relationships with state agency leaders and client account teams • Leads escalations and represents the organization in client meetings, audits, and RFP responses • Leads process improvement, standardization, and automation initiatives • Ensures compliance with contractual, regulatory, and security requirements and collaborates with compliance, legal, finance, and cross-functional leaders

🎯 Requirements

• Ten or more years of experience in Medicaid drug rebate • Bachelor's degree in business, finance, health care administration, information systems, or a related field, or equivalent combination of education and experience • Master's degree preferred • Experience in a supervisory or management capacity, including leading large teams • Proven experience leading client implementations and managing complex, multi-phase projects from kickoff through go-live and steady-state operations • Strong technical experience with rebate and claims systems, data structures, reporting and analytics tools, and process automation • Ability to partner effectively with IT and engineering teams • Strong financial acumen, including experience analyzing rebate performance, accounts receivable, and forecasting, and presenting financial results to executive audiences • Working knowledge of Medicaid and pharmacy programs and regulations that affect rebate, such as CMS requirements, state plan amendments, supplemental rebates, 340B, third party liability, and unit rebate amount calculations • Demonstrated success managing client relationships at the executive level, including contract performance, service level management, and issue escalation • Exceptional written and verbal communication skills, with the ability to explain technical and financial concepts clearly to both technical and non-technical audiences • Track record of developing leaders, managing change, and driving measurable operational improvements

🏖️ Benefits

• Work flexibility • Learning and career development • Generous, flexible vacation policy • 401(k) employer match • Comprehensive health benefits • Educational assistance • Leadership and technical development academies

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