- Establishes audit plan to review top 80% of contracted account formularies across commercial, Medicare Part D, and managed Medicaid channels.
- Reviews Teva products on each formulary and assesses compliance within stated terms and conditions of contract. Requests and obtains supporting documentation (prior authorizations, step edits, etc.) as need to complete assessment.
- Thorough understanding of Managed Care contracting as it relates to formulary access and tier position; Industry understanding of step-edits, NDC blocks, prior authorizations, copay differentials, preferred and non-preferred status is a plus.
- Ability to articulate comprehensive understanding of contract terms and conditions
- Advanced understanding of pharmaceutical rebate flow and decision points
- Minimum 5-7 years' experience in financial analysis.
- Minimum 2-3 years' experience working with drug formularies
- Advanced Excel skills
- Brand pharmaceutical business, specifically in market access
- Negotiation and presentation skills
- Understanding of drug purchase discounts and interaction with Rx based rebates
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Managed Care Analyst III - Parsippany, United States - Teva Pharmaceuticals
Description
Managed Care Analyst IIIDate:
May 3, 2024
Location:
Parsippany, United States, New Jersey, 00000
Company:
Teva Pharmaceuticals
Job Id: 55746
Who we are
Together, we're on a mission to make good health more affordable and accessible, to help millions around the world enjoy healthier lives.
It's a mission that bonds our people across nearly 60 countries and a rich, diverse variety of nationalities and backgrounds.
Working here means working with the world's leading manufacturer of generic medicines, and the proud producer of many of the products on the World Health Organization's Essential Medicines List.
Today, at least 200 million people around the world take one of our medicines every single day.An amazing number, but we're always looking for new ways to continue making a difference, and new people to make a difference with.
The opportunityThe purpose of the position is to identify and resolve compliance and eligibility issues with contracted managed care customers.
This position works with the Teva Market Access account managers and the contracted account to gain alignment on formulary product placement and compliance and to recover previously paid rebate or discounts in the event of noncompliant formulary findings.
Reporting to the Manager, Contract Compliance, the incumbent will be responsible for identifying and investigating formulary positions on PBM and Health Plan websites and formal Pharmacy Drug Lists (PDL) to validate product placement complies with all terms and conditions of the managed care contract.
Using critical thinking skills and data analytics, the incumbent will complete complex investigational audit reviews, identify risks and compliance issues and present findings both verbally and in writing to key internal and external stakeholders.
In addition, the Sr.Contract Compliance Analyst will participate in identifying and recommending contracting strategy changes as it relates to the effectiveness of the contract terms and conditions.
How you'll spend your dayExperience Required:
Preferred Experience:
We are strengthening and adding to our critical teams with great talent and capabilities: Teva, a global organization with a brand of evolving success.
We offer a competitive benefits package, including Medical, Dental, Vision, and Prescription coverage starting on the first day.
We also offer Disability and Life Insurance, Paid Time Off, 13 paid Holidays, 6% match on the 401(k), Employee Stock Purchase Plan, and Tuition Assistance.
Already Working @TEVA?If you are a current Teva employee, please apply using the internal career site available on "Employee Central". By doing so, your application will be treated with priority. You will also be able to see opportunities that are open exclusively to Teva employees.
Use the following link to search and apply:
Internal Career Site )
The internal career site is available from your home network as well. If you have trouble accessing your EC account, please contact your local HR/IT partner.
Teva's Equal Employment Opportunity Commitment
Teva Pharmaceuticals is committed to equal opportunity in employment.
It is Teva's global policy that equal employment opportunity be provided without regard to age, race, creed, color, religion, sex, disability, pregnancy, medical condition, sexual orientation, gender identity or expression, ancestry, veteran status, national or ethnic origin or any other legally recognized status entitled to protection under applicable laws.
We are committed to a diverse and inclusive workplace for all.If you are contacted for a job opportunity, please advise us of any accommodations needed to support you throughout the recruitment and selection process.
All accommodation information provided will be treated as confidential and used only for the purpose of providing an accessible candidate experience.
Important notice to Employment Agencies - Please Read CarefullyTeva Pharmaceuticals USA does not accept unsolicited assistance from agencies for employment opportunities.
All CVs / resumes submitted by search firms to any employee at our company without a valid written search agreement in place for this position will be deemed the sole property of our company.
No fee will be paid in the event a candidate is hired by our company as a result of an agency referral where no pre-existing agreement is in place.
Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails.EOE including disability/veteran
