Medicaid Senior Analyst

Job Description

Job Description

Job Title: Medicaid Senior Analyst Location: East Windsor, New Jersey Type: Direct Hire Compensation: $75,000.00 - $90,000.00 Work Model: Onsite Hours: 9 a.m. - 6 p.m. Overview: This role owns end-to-end Medicaid rebate operations across all 50 states and territories, including invoice validation, payment processing, and discrepancy resolution. You’ll lead dispute management and analytics, build dashboards and KPIs for leadership, and partner closely with Government Pricing and Finance on URA changes, restatements, accruals, and gross-to-net impacts. Ideal candidates bring 3–6 years of pharma Medicaid rebate experience, strong Excel and large-dataset skills, and hands-on experience with Medicaid rebate platforms (such as iContracts or Model N) plus an ERP (such as Oracle or NetSuite). Responsibilities:

• Manage the full invoice lifecycle for Medicaid rebate operations across all 50 states and territories, including receipt, validation, eligibility checks, unit/URA alignment, and timely payments in line with policy.
• Investigate and resolve invoice discrepancies such as NDC/labeler mismatches, utilization anomalies, packaging conversions, dual-eligible rejections, and duplicate claims.
• Maintain accurate Unit Rebate Amount (URA) usage and coordinate with Government Pricing for restatements and retroactive adjustments.
• Track and report weekly/monthly status updates including open disputes, credits taken, average resolution days, and aging.
• Lead structured dispute packages with data, rationale, precedent, and correspondence; monitor outcomes and escalate when necessary.
• Build dashboards and KPIs for leadership, including claims volume, acceptance rate, dispute success rate, recovery dollars, cycle time, and resolution aging.
• Administer state supplemental rebate programs by maintaining contract repositories, pricing terms, product addenda, and renewal calendars.
• Ensure invoice adherence to rebate terms and coordinate accruals and true-ups with Finance.
• Collaborate with the Government Pricing team on pricing changes impacting URA, NDC updates, product launches, and restatements.
• Support CMS reporting and coordinate impacts to Medicaid rebates and GTN, monitor 340B interactions, and address duplicate discount risks.
• Maintain SOPs for rebate processing, disputes, supplemental rebates, and documentation for audits.
• Own day-to-day utilization of Medicaid rebate systems such as iContracts, interfaces with ERP/BI tools, and drive automation and process standardization.
• Partner with IT and Data teams to improve data quality and reporting capabilities.
• Work closely with Commercial Finance on accruals, true-ups, cash forecasting, and provide Medicaid insights for business initiatives like product launches and pricing.

Requirements:

• Bachelor’s degree in Accounting, Finance, Business, Supply Chain, Data/Analytics, or related field
• 3–6 years of relevant pharma experience, including Medicaid rebates
• Hands-on experience with Medicaid rebate processing platforms (e.g., iContract, Model N, Vistex/Revitas/Revenue Cloud) and ERP systems (Oracle, NetSuite)
• Strong Excel and data analysis skills; comfortable working with large datasets and reconciliations
• Understanding of MDRP fundamentals (AMP, Best Price, URA, invoicing cycles) and dispute methodologies
• Proven ability to manage deadlines across multiple states with high accuracy and controls
• Preferred: experience with 340B, VA/FSS, TRICARE, and state supplemental rebate programs
• Knowledge of Government Pricing calculations (AMP, BP, NFAMP, PHS Ceiling Price) and GTN accounting concepts (accruals, true-ups, reserves)