- Review and approve rebate claims data received for managed care contracts, Medicare Part D contracts, and other commercial and government programs. Validate rebate submissions and process payments in accordance with contracts terms and company policies.
- Manage the commercial rebate team to process formulary validations and exclusions with direct supervision of two rebate analysts and oversight of an outsourced BPO services team.
- Maintain a detailed data file of exclusions in agreement with contract language and pharmacy lists, with exclusion type, brand/NDC data and aging (date) information. Reconcile exclusion data to PBMs invoices. Supervise the resolution and recovery of contract exclusions. Facilitate communication with market access, finance and PBMs related to exclusions, disputes, and resolutions.
- Manage the outsourced BPO services team to identify and track disputes and communication with payors.
- Oversee the 340b claims scrubbing and validation process.
- Review, analyze and calculate the impact of proposed price increases on contract rebates, including the impact of price protection clauses on commercial, managed care contracts and Medicate Part D contracts. Manage and maintain Managed Care price protection models used to track and calculate price protection penalties.
- Track actual managed care and Medicare Part D rebates, identify variances from forecasted projections and determine reasons for variances and report to forecast team for forecast updates.
- Prepare analysis to support forecasted utilization rates for managed care and Medicare Part D contracts.
- Manage fee-for-service contracts with wholesalers and distributors, including oversight of one analyst and an outsourced BPO services team to process wholesaler and distributor fees. Partner with brand and generics trade team(s) to process contract updates, invoice analysis, and payment approvals.
- Maintain a strong controls and compliance environment including the maintenance of the risk control matrix, audit support, and the periodic SOX sub-certification.
- Lead and/or support special projects, as assigned.
- Bachelor's degree in finance, accounting or a related discipline required
- 8 years of experience with 5 years of experience with commercial contracting and rebates
- Ability to think strategically and work independently
- Interested candidates must possess high ethical standards, strong verbal and written communication skills, strong technical skills and flexibility in handling changing priorities and tight deadlines
- Ability to work in a cross-functional group and interact with senior leadership
- Ability to use advanced Excel spreadsheet functions and formulas to build and maintain models for calculating and forecasting gross-to-net deductions.
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Senior Manager, Finance Commercial Contracts - Bridgewater, United States - Bausch Health Companies Inc.
Description
Bausch Health is a global company that develops, manufactures, and markets a differentiated product portfolio across multiple high-growth therapeutic areas including Gastroenterology, Generics, Neurology, Ortho Dermatologics, Medical Aesthetics and Dentistry. We are delivering on our commitments as we build an innovative company dedicated to advancing global health. Each day, Bausch Health products are used by over 150 million people around the world.
Our approximately 7,000 employees are united around our mission of improving people's lives with our health care products.
Reporting to the Senior Director, Finance (Revenue & GTN Accounting), the Senior Manager, Finance Commercial Contracts & Rebates will be an integral member of the US revenue accounting team. This position is in Bridgewater, NJ and is responsible for managing and accounting for Commercial and Medicare Part D contracts and will oversee the daily operations of the contract management function. This individual will ensure proper communication between account managers, customers, managed care organizations and other vendors.
Areas of responsibility -
Other duties
REQUIRED EDUCATION/SKILL/ABILITIES
Benefits package includes a Comprehensive Medical (includes Prescription Drug), Dental, Vision, Health Savings Account with company contribution, Flexible Spending Accounts, 401(k) matching, discretionary time off, paid sick time, tuition reimbursement, parental leave, short-term disability, long-term disability, life insurance, accidental death & dismemberment insurance, paid holidays, Employee Assistance Plan, commuter benefit, recognition awards, voluntary benefits (including Identity Theft, Student Loan and Breast Milk Shipping), employee referral bonuses and employee discounts.
LI-hybrid
This position may be available in the following location(s): US - Bridgewater, NJ
We thank you in advance for your interest in growing and developing with our company. Kindly note that in order for all stakeholders to be successful, we do require a minimum of one year in your current role before applying to another one. Please ensure you have discussed with your current manager the intent of applying to a new role.
Any exception will have to be authorized by your HR Business Partner.
We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment regardless of race, color, religion, gender, national origin, age, sexual orientation, gender identity or expression, marital or veteran status, disability, or any other legally protected status. We are committed to building diverse teams, representative of the patients and communities we serve, and we strive to create an inclusive workplace that cultivates collaboration.
If a candidate needs a reasonable accommodation/adjustment due to physical or mental health impairment for any part of the application process, they are encouraged to send their request to or call and let us know the nature of the request and their contact information. Please be sure to include the job requisition number.
Job Applicants should be aware of job offer scams perpetrated through the use of the Internet and social media platforms.
To learn more please read Job Offer Fraud Statement.
