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Claims Administration Manager

  • GE Healthcare
  • Experienced
  • Posted 12/10/2016 8:42:06 PM
  • 2681435
  • Job Function: Sales
  • Business Segment: Healthcare Life Sciences
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

GE offers a great work environment, professional development, challenging careers, and competitive compensation.  GE is an Equal Opportunity Employer.  Employment decisions are made without regard to race, color, religion, national or ethnic origin, sex, sexual orientation, gender identity or expression, age, disability, protected veteran status or other characteristics protected by law.
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