Director, Rebate Contract Operations
Lumicera Health Services is defining the “new norm” in specialty pharmacy to optimize patient well-being through core principles of transparency and stewardship. Our team members work in an environment that celebrates creativity and fosters diversity.
About the role
The Director, Rebate Contract Operations is responsible for all operational aspects of Lumicera’s contract program, including core operations, client operations, contract optimization, sales support, pricing/guarantees, point of sale contracts, and vendor management.
Responsibilities
- Data flow between Lumicera Contracts team and other internal stakeholders like finance, analytics, sales, and account management.
- Data flow between Lumicera, GPO, Pharma, and/or other vendors, including submission of claims data.
- Work with IT to prioritize and deliver solutions enabling all data flow needs.
- Account Reconciliation file receipt, analysis, and furnishing the necessary data so finance can invoice clients.
- Complete audits.
- Implementation of New Clients, involving evaluation of formulary from a roll-up standpoint.
- Prospective Reporting, including:
- Forecasting/projecting rates based on existing data, making assumptions, and documenting such assumptions/caveats.
- Creating a potential bid grid based on known data components, documenting assumptions.
- Constantly comparing actuals vs. forecasted to fine-tune assumptions.
- Forecasting guarantees based on rates, utilization, and other factors like inflation.
- Retrospective Reporting to ensure all client reports are generated timely and accurately. Analyzing data to ensure clients receive maximum contract value. Identifying gaps and working with key stakeholders to correct them.
- Contract Optimization to analyze client formulary against best formulary placement with pharma and GPO. Supply data/information needed for meaningful conversations to maximize client contracts while maintaining lowest net cost philosophy.
- Ensure RFPs are responded to in a timely and accurate manner.
- Ensure guarantees are developed using appropriate methodology, accounting for risk and aligning with Implementations and Sales.
- Understand client and regulatory requirements around the service.
- Operationalize the service by working closely with other operational areas like formulary and claim adjudication to ensure accuracy of setup.
- Work closely with vendors or strategic partners to ensure mutually successful partnerships, including:
- Aligning strategic priorities with partners.
- Tracking performance of vendors against guarantees.
- Tracking the dispute resolution process.
- Creating dashboards that capture current state comprehensively.
- Other duties as assigned.
Requirements
- Bachelor’s degree or equivalent work experience required.
- 2 years in a PBM, GPO, or equivalent setting required.
- Proven experience in designing an operation, building processes, and scaling and automation required.
- Proven track record of process improvement/system enhancements required.
- Experience with tools/systems around automation of processes preferred.
- Proven track record of collaboration with multiple stakeholders, internal and external, required.
- Leadership experience required.
- Experience working with Senior Leadership within an organization required.
- Participate in, adhere to, and support compliance program objectives.
- The ability to consistently interact cooperatively and respectfully with other employees.
Benefits
- Top-of-the-industry benefits for Health, Dental, and Vision insurance.
- 20 days paid time off.
- 4 weeks paid parental leave.
- 9 paid holidays.
- 401K company match of up to 5% – No vesting requirement.
- Adoption Assistance Program.
- Flexible Spending Account.
- Educational Assistance Plan and Professional Membership assistance.
- Referral Bonus Program – up to $750!
Pay
USD $142,128.00 - USD $177,660.00 / year, plus a STAR Bonus (At-Risk Maximum) of 15%.
Schedule
Monday to Friday, 8:00 AM to 5:00 PM.
Location
Remote (U.S. only). Attention: Lumicera is unable to offer remote work to residents of Alaska, Connecticut, Delaware, Hawaii, Idaho, Kansas, Kentucky, Maine, Massachusetts, Mississippi, Montana, New Hampshire, New Mexico, North Dakota, Rhode Island, South Carolina, South Dakota, Vermont, Washington DC, West Virginia, and Wyoming.