Medicaid Senior Analyst
Job in
Hightstown, Mercer County, New Jersey, 08520, USA
Listed on 2026-07-08
Listing for:
Integrated Resources, Inc
Full Time
position Listed on 2026-07-08
Job specializations:
-
Government
Financial Compliance, Financial Reporting, Financial Analyst
Job Description & How to Apply Below
Medicaid Rebate Operations
- Manage the full invoice lifecycle for all 50 states and territories: receipt, validation, eligibility checks, unit/URA alignment, and timely payments in line with policy..
- Investigate and resolve invoice discrepancies (e.g., NDC/labeler mismatches, utilization anomalies, packaging conversions, dual eligible rejections, duplicate claims).
- Maintain accurate Unit Rebate Amount (URA) usage and coordination with Government Pricing for restatements/retroactive adjustments.
- Track and report weekly/Monthly status: open disputes, credits taken, average days to resolve, and aging.
- Analyze state utilization trends and outliers (e.g., spikes by NDC/state, abrupt mix changes).
- Lead structured dispute packages (data, rationale, precedent, correspondence) to states; monitor outcomes and escalate when needed.
- Build dashboards/KPIs for leadership (claims volume, acceptance rate, dispute success rate, recovery dollars, cycle time, resolution aging).
- Administer state supplemental rebate programs: maintain contract repository, pricing terms/effective dates, product addenda, and termination/renewal calendars.
- Validate invoice adherence to supplemental rebate terms and coordinate accrual/true up with Finance.
- Collaborate with GP team on pricing changes impacting URA , NDC changes, product launches, and restatements.
- Support GP with data validation needed for CMS reporting and coordinate impacts to Medicaid rebates and GTN.
- Monitor 340B interactions and potential duplicate discount risk; ensure appropriate processes with covered entities/third party administrators.
- Maintain SOPs/work instructions for rebate processing, disputes, supplemental rebates, and evidence retention.
- Support internal/external audits (Medicaid, GP, 340B) with complete, accurate documentation and timely responses.
- Own day to day utilization of the Medicaid rebate system
-iContracts and interfaces with ERP/BI tools. - Drive automation and standardization to reduce manual touchpoints, error rates, and cycle times.
- Partner with IT/Data to improve data quality(inner NDCs, unit of measure, package size conversions) and enhance reporting.
- Work closely with Commercial Finance on accruals, true ups, cash forecasting, and gross to net analytics.
- Provide Medicaid insights for business cases (product launches, pricing actions, channel mix shifts).
Required
- 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 with a Medicaid rebate processing platform (e.g., iContract, Model N, Vistex/Revitas/Revenue Cloud, or similar) and ERP (e.gOracle, Net Suite).
- Strong Excel and data analysis skills; comfort with large datasets and reconciliations.
- Demonstrated understanding of MDRP fundamentals (AMP, Best Price, URA, invoicing cycles) and dispute methodologies.
- Proven ability to manage deadlines across multiple states while maintaining high accuracy and controls.
Preferred
- Experience with 340B, VA/FSS, TRICARE, and state supplemental rebate programs.
- Exposure to Government Pricing calculations (AMP, BP, NFAMP, PHS Ceiling Price).
- Knowledge of GTN accounting concepts (accruals, true ups, reserves)
.
- BS/BA preferred.
- Minimum 3 years of experience.
- Generic Pharmaceutical experience highly preferred (generic or brand).
- Medical and Rx Benefits choice of four medical plans through Client. Rx automatically provided with medical benefits
- Dental Benefits with three dental plan options through Client
- Vision Plan with two plan options through VSP
- Life Insurance, Basic Life and AD&D and Supplemental Life Insurance
- Disability Insurance, Voluntary Short-Term Disability and State Disability
- Long-Term Disability (LTD), State (short term) disability where applicable
- FSA (Flexible Spending Accounts) Both Health Care & Dependent Care Available
- HSA (Health Savings Account)
- 401(k) Plan
- Through Fidelity / Employer Match / fully vested after 3 years - Employee Assistance Program (EAP) - 100% Confidential and 100% company paid
- Critical Illness and Accidental Insurance
- Legal and Identity Theft Insurance
- Paid Time Off
- Paid vacation, PTO, Holiday
" Ability to sit at a computer terminal for an extended period of time Sedentary work Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift,…
Position Requirements
10+ Years
work experience
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