The opportunity
The 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.
How you’ll spend your day
Review Managed Care Contracts, Formularies, Utilization Management, and PA policies to identify formulary/contract non-compliant findings.
Analyzes and resolves disputes with accounts involving contract interpretation, utilization management, and/or formulary positioning. Engages Managed Markets members as needed and other internal teams.
If applicable accounts are in post-audit schedule, help Manager/AD conduct analysis on post-audit findings.
Tracks and communicates recoverability rates and financials for data accuracy and reporting.
Aids in the delivery of key information in support of rebate modeling, contract performance assessment, and financial analysis.
Communicates financial impacts to key internal stakeholders such as Revenue Accounting and Gross to Net.
Understands fundamental mechanics of claims validation, rebate systems, and outside formulary tools such as MMIT and FingerTip Formulary.
מלאה
פורסם לפני חודש 1
פורסמה ברשת