Location(s): United States ; Massachusetts; Marlborough
Role Summary: The Claims Administration Manager functions as the point of contact for the contracting operations process who is responsible for implementing and updating pricing and contracts within our system; setting up and maintaining memberships and affiliates; and managing the chargeback and fee payment process.
Essential Responsibilities: • Manage the end-to-end contracting and pricing implementation process to meet/exceed business cycle time requirements.
• High level of influencing skills to manage cross functional issues and drive timely decisions across the commercial and cross-functional organizations.
• Act as liaison between cross-functional team to implement contracts that drive revenue and support contract compliance.
• Managed a team of professionals responsible for data implementation and maintenance including: customers, pricing, membership, creation of contracts, and payments of rebates and administrative fees.
• Oversee the chargeback process and coordinate efforts to sustain a strong partnership with external customers.
• Gather and analyze wholesaler chargeback data to ensure accurate and timely payment of rebates and administrative fees.
• Work with cross-functional team to communicate results of chargeback research and assist with corrective actions to reduce recurring chargebacks.
• Manage the escalation of issues related to chargebacks as appropriate and ensure proper documentation support, approvals and sign-offs are obtained.
• Maintain accurate pricing by product item and contract tier levels for all executed contracts.
• Implement amendments and extensions with GPOs, IDNs and Wholesalers to ensure contracts are updated in a timely manner.
• Update contract pricing to reflect price increases by contract as required.
• Provide assistance to resolve issues with regard to pricing, contracting, and other information requests.
• Generate monthly/quarterly sales volume and administration fee reports according to terms of GPO agreements.
• Create administrative fee check requests, validate payment amount with cross-functional approvers to assure that payments are made in accordance with contract terms.
• Develop a working knowledge of contract pricing and administrative fee terms and conditions in order to ensure we meet our contract obligations.
• Process membership additions and deletions identified on published lists and review each major GPO list according to standard operating procedures.
• Familiarity with contracting and reporting mechanisms (e.g. CMS/CARs, Emptoris, Excel, Support Central Workflow).
• Support periodic reporting and performance presentations
Qualifications/Requirements: • Bachelor’s Degree with at least 8 years of experience in contract and price implementation or a similar role
• Minimum of 5 years of experience with chargebacks, rebates and administrative fees
• Proven leadership skills including the ability to motivate cross functional teams to achieve business goals
• Strong business acumen, including a strong financial background
• Profit & Loss (P&L) and field sales exposure
• Ability to develop and execute priorities and approaches to meet objectives
• Language proficiency in English
Desired Characteristics: • MBA or Finance degree preferred
• Detailed oriented and ability to work in a collaborative team environment
• Strong oral and written communication skills
• Strong interpersonal, influencing, and leadership abilities
• Demonstrated experience prioritizing conflicting demands from multiple business clients in an extremely fast paced environment
• Solid understanding of the healthcare environment
• Prior experience doing business with governmental entities
• Strong financial acumen with an understanding of contractual accounting methodologies
• Strong coordination and project management skills
Locations: United States ; Massachusetts; Marlborough
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