Performs the calculation, analysis and submission of all mandated product and pricing data for all federal and state government pricing programs. Process current/prior quarter Medicaid invoices and submit payment package. Responsible for resolution of apparent data discrepancies and providing relevant supporting documentation to government agencies, as needed including CMS (Centers for Medicare and Medicaid Services), HRSA (Health Resources and Services Administration) and the VA (Veterans Administration).
Essential Duties & Responsibilities
- An experienced professional with an understanding of government pricing programs; responsible for working with third party provider to accurately calculate all statutory pricing requirements including AMP, BP, URA, ASP, Non-FAMP and FCP within the allotted timelines on a monthly, quarterly, and annual basis, as required.
- Performs re-calculation of statutory pricing requirements, as needed, and provide analysis on financial impact to 340B, Medicaid and/or VA.
- Process quarterly Medicaid invoices in Model N to include retrieving e-invoices or scanning mail invoices, loading invoices in Model N, identify and resolving disputes with Medicaid state representative, submitting invoice for payment, and creating payment packages.
- Maintains working knowledge of the Medicaid Drug Rebate Agreement, the Federal Supply Schedule agreement, 340B Pricing, and regulatory/legislative changes that impact pricing, contracts, and all Federal and State statutory calculations.
- Reviews and analyzes customer pricing, class of trade and transactional data for correct classification and inclusion/exclusion in the government pricing calculations.
- Performs analysis on fluctuations in reported pricing and provides detailed explanations for significant increase or decrease and generates monthly/quarter presentation for leadership.
- Collaborates with various departments to resolve all source system data issues identified in the data reconciliation and validation process prior to calculations being processed
- Provides support and back up for the Manager, Government Reporting & Rebates including updates/changes to department policies/procedures to allow for continuous business process improvement.
- Maintains appropriate written and electronic documentation consistent with approved policy and various state and federal requirements.
- During slow period of Medicaid Rebate Processing the GP Analyst will also provide capacity for Commercial Rebate Processing:
- This role supports the timely, accurate and complete processing of customer rebates, including Hospitals, Group Purchasing Organizations, Wholesalers and Distributors, Individual Distribution Networks and Health Systems. Customer relations are a key success factor as there is heavy interaction with customers, contracting & sales organization and IT support.
- Normally receives little instruction on day-to-day work, general instructions on new assignments.
- Assists with various projects as assigned.
- Work on special projects as they arise.
Knowledge & Skills
- Organized and very attentive to detail with a high degree of accuracy to ensure compliance with timelines, internal policies, laws and regulations.
- Proven analytical and problem-solving skills.
- Strong Excel and Word skills are required, Model N and Oracle ERP strongly preferred.
- Effective written and oral communication skills.
- A self-starter with ability to work independently to manage multiple tasks, priorities and timelines.
- Ability to successfully interact with upper management and external government contacts.
Minimum Qualifications, Education & Experience
- Must be at least 18 years of age
- Bachelor’s degree in Business, Finance, or Accounting from an accredited college or university is required
- Experience in Government Pricing and Contracting preferred with a minimum of 3 years of experience in the Pharmaceutical Industry
- This is largely a sedentary role.
- This job operates in a professional office environment and routinely uses standard office equipment.
- Typically requires travel less than 5% of the time
ICU Medical is an Affirmative Action and Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, or protected veteran status and will not be discriminated against on the basis of disability.
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