Medicaid Contracting Specialist

Grifols - Durham, NC3.2

Full-timeEstimated: $70,000 - $93,000 a year
Grifols is a global healthcare company whose mission is to improve the health and well-being of people. Our three divisions –Bioscience, Diagnostic and Hospital–develop, produce and market our innovative products and services to medical professionals in more than 100 countries.

We are committed to fostering an environment that creates continuous learning opportunities and encourages professional development and growth. As a company devoted to improving the health and well-being of people, we are looking for talented professionals worldwide. Make a difference and join us in this challenging and rewarding enterprise.

The Medicaid Contracting Specialist is responsible for the administration and analysis of all Medicaid, Medicare, and TRICARE invoices, including reviewing and validating submissions, processing and paying rebates, and analyzing quarterly utilization and rebate trends and variances.

Primary Responsibilities:
Support the accurate and timely Medicaid rebate claims processing, payment, and dispute management. Disputes include communication and negotiation with the state government entities to validate our products and their utilization ensuring accurate payment of claims.
Prepare and maintain system entries for Medicaid, Medicare, and TRICARE
Prepare accurate rebate reports for management and other stakeholders, including variance analysis, forecasting, and accruals.
Ensure SOX compliance by providing support and assistance to audit initiatives.
Support and test Medicaid system upgrades, enhancements, and reporting.
Support the maintenance of Medicaid policies, SOPs, and reasonable assumptions consistent with state and federal regulations.
Establish strong working relationships with internal partners, including AP, Finance, Contracting, and IT to support operational excellence.

Essential Skills:
Ability to work productively within a team environment and perform duties independently or with a low level of supervision is required.
Must have excellent oral and written communication skills as job responsibilities include communicating with various levels of management within and outside of the company.
The position demands the ability to respond to a high volume of work with a high level of intensity dictated by the requirement for absolute accuracy within an expedited turnaround time. This position is dynamic in nature due to the evolving legislative and legal environment; therefore, it requires an ability to respond to change and a need for constant reprioritizing to satisfy demands of rapidly changing environment.
Success in this position requires an extraordinarily high attention to detail and organization with a high degree of follow up & follow through are necessary to keep all tasks prioritized.
Additional responsibilities may be assessed as appropriate.

Candidate must:
Proficient in Microsoft Office Suite
Experience with Revitas Flex
Strong communication skills with internal and external customers
Must be able to work independently and in a team environment
Must possess strong business, analytical and organizational skills

Bachelor's Degree in Business, Economics, Health Administration, Accounting or Related Field

3+ years business experience, preferably with a concentration in data analysis, contracting, government claims related activities or financial analysis.

Equivalency: Bachelor’s degree or 3 years experience in the Medicaid Claims area in the Pharmaceutical industry.

Work is performed in an office environment with exposure to electrical office equipment. Frequently sits for 6-8 hours per day. Repetitive hand movement of both hands with the ability to make fast, simple, repeated movements of the fingers, hands, and wrists. Occasionally walks and stands. Occasionally bends and twists neck. Light to moderate lifting and carrying objects with a maximum lift of 25lbs. Frequently drives to site locations with occasional travel within the United States. Able to communicate information and ideas so others will understand; with the ability to listen to and understand information and ideas presented through spoken and written words and sentences. Interacts with others, relates sensitive information to diverse groups. Must work with diverse groups to obtain consensus on issues.


Location: NORTH AMERICA : USA : NC-RTP:USNC0001 - RTP NC-Headquarters