Membership Administrator, Managed Care (50530640) Stamford, Connecticut
The primary objective of this position it to support the administration of contract membership in assigned managed care contracts, in order to ensure Purdue guidelines and policies are adhered to as well as customer compliance with rebate contracts.
- Review formularies, plan lists, plan list updates, utilization, as well as other information provided from the customer, and perform online research for assigned managed care rebate customers to determine compliance of plan types, plan benefit designs, and product formulary positioning, using contract terms and Purdue guidelines, for various rebate eligibility levels. Using CARS/AMM or ContractSphere Advanced Membership or manual entry in CARS or ContractSphere (as appropriate), accurately update and maintain managed care rebate contract membership in the system as plan lists/updates are received and as formularies are reviewed. Verify and set up all plans for the new or renewal contract period of any managed care contract.
- Effectively communicate and respond timely to the rebate group in the Finance department on membership issues and updates, including plan and product rejections, pricing adjustments, and language in customer rebate letters as interpreted using the contract terms.
- Request membership and/or contract information (in a timely manner) from customers directly or through Account Executives to investigate eligibility of certain plans. Coordinate resolution of membership issues with Account Executives and Finance rebate group as necessary.
- Handle drafting and administration of general contract correspondence relating to assigned managed care contracts.
- Identify and work to resolve issues and trends with rebate submissions with Supervisor and Account Executive (as appropriate). Updating of departmental tracking logs as appropriate for assigned managed care contracts to ensure completeness of rebate submissions.
- Ad hoc requests as assigned .
Bachelors degree is required.
Required Experience & Technical Requirements
Minimum of 2-3 years previous work experience in a corporate environment is required.
Proficient in Outlook, MS Excel and MS Word. Knowledge of SAP®, CARS/IS®, ContractSphere® or other pharmaceutical contract/rebate/membership systems preferred, but not required.
General understanding of managed care and pharmaceutical industry preferred from either the pharmaceutical manufacturer or health care plan perspective.
Skills: Superior business writing and verbal communication skills are required. Must be able to work under tight deadlines, with multiple stakeholders, and on multiple tasks concurrently, as well as prioritize effectively.