Job Details
Location:
Concord Pike, New Castle County, Delaware, 19803, USA
Posted:
Feb 10, 2021
Job Description
The Contract Operations Specialist is responsible for working with internal/external customers on all aspects of Market Access; Master Data, Contracting, Membership, Chargebacks and Rebates. They are responsible for the receipt, analysis, impact, resolution and posting/reporting of all contractual payments across multiple customer segments including Health Plans, GPOs, Specialty Pharmacies, Physicians and Wholesalers as well as maintaining all related documentation for those payments. The Contract Operations Specialist is responsible for developing Market Access contracts including: template development, strategy interpretation, language negotiation, approval, and execution In this role, they will manage and meet deliverables of business operations to monitor, evaluate and administer claims to be paid and ensure payments are accurate, timely, formulary compliant and entered in contract systems consistent with agreement terms, following corporate controls/approved guidelines and SOX regulations. They are expected to establish and maintain collaborative working relationships with internal/external contacts and peers to ensure effective communication and a high-level of customer service to support successful implementation and execution of contract terms and payments. Contract Operations Specialist must possess an in-depth knowledge of claims processes, systems and an understanding of Market Access contracting processes and strategies to ensure contract compliance.
Typical Accountabilities
- Validate, Monitor and Update Customer Master Data.
- Work with Customer Facing Team and Customers to obtain accurate membership rosters
- Process, monitor, review, measure, track, validate, research, analyze and report on customer activity/utilization reported by contract customers, wholesalers, and others using chargebacks, rebates and sales data.
- Understand and interpret contract language and regulations as it relates to contract setup and maintenance to ensure accurate calculation of customer reimbursements.
- Develop and maintain strong working relationships to facilitate the exchange of key information, understand and address needs, and clarify contract requirements with internal and external customers.
- Collaborate with peers to handle priorities and coordinate efforts with a focus on providing excellent customer service.
- Contribute to contract management and strategy approaches through knowledge of reimbursement arrangements and potential business operations capabilities.
- Meet and understand all compliance-related requirements such as completion of mandatory training, adherence to audit controls, and adherence to all AZ policies, SOPs, job aids, and Sarbanes-Oxley requirements.
- Participate on cross-functional teams lending support and input from a Market Access perspective as well as special projects as assigned by management.
- Develop and communicate reporting techniques/tools emphasizing trend analysis as it relates to strategy development, contract performance, and compliance.
- Proactively seeks and recommends enhancements and improvements in Market Access claims processes, including recommending resources, innovative approaches, negotiating agreeable solutions, or involving next-level management as needed.
Essential
- Bachelor’s degree; preferably in a relevant field
- Contract Language Experience
- Logic and mathematical skills
- Highly proficient in Excel, Word & Power Point
- Demonstrated ability to manage multiple tasks/projects simultaneously
- Strong communication skills
- Strong attention to detail and trends
Desirable
- MBA
- Understanding of AZ business model with specific knowledge of contract operations
- Pharmaceutical or related healthcare business experience