To protect the assets of Human Pharma business and to provide strategic recommendations to Senior Management in the Managed Markets of Federal and Medicaid, consistent with business goals. For Medicaid, this is accomplished by managing the Medicaid rebate operations team for BIPI which includes claim processing, dispute resolution, quarterly CMS pricing compliance, reviewing of business cases, and systems development. For Federal, this is accomplished by performing all necessary tasks to establish and maintain our Federal contracts for BIPI. Research and evaluate new legislation and ideas and debrief management on findings to obtain the best possible positioning for this market. Establish the Federal and Medicaid compliance training for other employees, maintain SOP’s, as well as self-audits as needed. Lead for all internal and external audits regarding Medicaid and Government pricing.
As an employee of Boehringer Ingelheim, you will actively contribute to the discovery, development and delivery of our products to our patients and customers. Our global presence provides opportunity for all employees to collaborate internationally, offering visibility and opportunity to directly contribute to the companies’ success. We realize that our strength and competitive advantage lie with our people. We support our employees in a number of ways to foster a healthy working environment, meaningful work, diversity and inclusion, mobility, networking and work-life balance. Our competitive compensation and benefit programs reflect Boehringer Ingelheim’s high regard for our employees.
Duties & Responsibilities:
- Responsible for ensuring compliance in Medicaid rebate and Federal pricing programs. Maintain policies and procedures manual for both programs.
- Lead the development and ongoing maintenance of the quarterly pricing submissions for BIPI with all State and Federal Programs (AMP, ASP, BP, FCP, NFAMP, and PHS, etc.).
- Ensure all Medicaid and non-Medicaid rebate payments are paid accurately and in timely manner. Ensure that validation guidelines are evaluated with the changing regulatory environment and are applied properly to claim payments.
- Aggressively strive to settle all disputed rebate claims. Continually develop and refine dispute resolution strategies on a state by state basis.
- Responsible for the monitoring of Sales Discounts for all Government rebate programs. Provide treasury with monthly cash forecasts. Track Medicaid payments and accruals on a monthly basis.
- Constantly evaluate the overall effectiveness of Model N Medicaid processing and CDL delivery. Continuously assess alternative validation sources that could potentially enhance our claims processing and dispute resolution processes.
- Responsible for managing all state pricing transparency reporting requirements and proactively planning for future needs.
- Recruit, train, coach and lead a team to deliver on the above outcomes.
- Bachelors degree from an accredited institution required.
- MBA or advanced degree certification, such as a CMA or CPA preferred.
- Requires eight to ten (8-10) years of experience working within a financial environment (preferably within the pharmaceutical industry).
- Minimum five (5) years of experience in Federal and Medicaid markets in order to properly lead the management of this complex space and provide effective guidance to complex problems in a dynamic fast paced environment.
- Experience in the ensuring process compliance.
- Expertise in Medicaid, government pricing calculations.
- Demonstrated leadership skills and ability to manage a small team.
- Must be legally authorized to work in the United States without restriction.
- Must be willing to take a drug test and post-offer physical (if required).
- Must be 18 years of age or older.
Who We Are:
At Boehringer Ingelheim we create value through innovation with one clear goal: to improve the lives of patients. We develop breakthrough therapies and innovative healthcare solutions in areas of unmet medical need for both humans and animals. As a family owned company we focus on long term performance. We are powered by 50.000 employees globally who nurture a diverse, collaborative and inclusive culture. Learning and development for all employees is key because your growth is our growth.
Want to learn more? Visit boehringer-ingelheim.com and join us in our effort to make more health.
Boehringer Ingelheim is an equal opportunity global employer who takes pride in maintaining a diverse and inclusive culture. We embrace diversity of perspectives and strive for an inclusive environment, which benefits our employees, patients and communities. All qualified applicants will receive consideration for employment without regard to a person’s actual or perceived race, including natural hairstyles, hair texture and protective hairstyles; color; creed; religion; national origin; age; ancestry; citizenship status, marital status; gender, gender identity or expression; sexual orientation, mental, physical or intellectual disability, veteran status; pregnancy, childbirth or related medical condition; genetic information (including the refusal to submit to genetic testing) or any other class or characteristic protected by applicable law.
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