Prabhdeep Singh

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Senior Associate - Government Contracts - Medicaid Job

Date: Jan 2, 2019

Location: Plainsboro, NJ, US

Company: Novo Nordisk

About the Department
At Novo Nordisk, our Finance and Operations team works to provide strategic direction to the company, ensuring that everything we do is viable and built to last. Overseeing and safeguarding Novo Nordisk Inc (NNI’s) short and long-term planning, Finance and Operations works closely with teams across the organization to develop strategies and business plans, monitor industry trends and provide operating recommendations. We regulate accounting, uphold workplace safety, manage our supply chain and sampling, support technology, maintain our facilities and assure the integrity and completeness of all business transactions. At Novo Nordisk, you will have the opportunity to build a life-changing career in a global business environment. We encourage our employees to make the most of their talent. And we reward hard work and dedication with the opportunity for continuous learning and personal development. Are you ready to realize your potential?

The Position
Responsible for processing and reconciling the Medicaid rebate claims utilizing the Model N Medicaid System. Regularly coordinates with State Medicaid agencies, contract administrators and assists with analyses on resolutions. Ensures NNI compliance with the Medicaid Drug Rebate Program (MDRP).

Reports to a manager in Government Contracts - Medicaid. Internal relationships include Government Contracts – Pricing, Pricing, Contract Operations & Reimbursement and general finance. External relationships include Centers for Medicaid and Medicare Services (CMS), State Medicaid agencies and Pharmacy Benefit Administrators.

Essential Functions
  • Attends Financial Planning &Analysis (FP&A) forecasting meetings and provides guidance to FP&A Department on potential future Medicaid events that could impact rebate forecasting
  • Analyzes and ensures accuracy of state rebate formatted data for each level of processing
  • Assists management in Government Compliance regarding pricing and reporting issues as required
  • Prepares and provides standard Medicaid rebate reports to field and home office management. These reports include state utilization trending, claim receipt status, reconciliation of state invoice and ad-hoc reporting
  • Prepares Medicaid data analyses to explain variances between rebate periods
  • Reviews and analyzes contract terms and conditions; ensures data in the Model N Medicaid system reflects the current contract terms for accurate processing
  • Acts as company liaison, negotiating with state Medicaid agencies and Pharmacy Benefit Administrators regarding dispute resolution with a third party Consultant
  • Assists internal & external customers with inquiries relating to Medicaid payments, dispute and contracts
  • Builds and maintains relationships with internal stakeholders to build an understanding of business objectives
  • Coordinates Medicaid claim data entry with third party vendor
  • Coordinates Medicaid disputes with third party dispute vendor and provides periodic reporting to Senior Management
  • Develops and distributes quarterly analysis of Medicaid Rebate Liability
  • Ensures compliance with all state mandated due dates by avoiding interest penalties at all times
  • Ensures that all dispute inquires and claim level details received from the States are submitted to dispute resolution consultant in a timely manner
  • Maintains knowledge in operation of Model N Medicaid Rebate Processing system
  • Prepares/reviews quarterly Federal Medicaid, ADAP, SPAP (State Programs), and Supplemental Invoices; prepares/reviews prior quarter adjustments as necessary
  • Responsible for the timely and accurate payments of all Federal and State Medicaid Rebate claims
  • Reviews state utilization data for reasonableness and quantifies and accounts for Medicaid dispute exposure
  • Serves as point of contact for all State Medicaid customers regarding rebate payment inquiries
  • Stays up-to-date and applies knowledge of the Medicaid Rebate legislation to all Federal and individual State programs
  • Assists internal and external customers with inquiries relating to Medicaid payments, dispute resolution and contract inquiries
  • Coordinates the implementation of Medicaid system enhancements and testing
  • Coordinates with Accounts Payable and IT regarding SAP interface check requests and wire transfers
  • Formats incoming claims data from Medicaid contract customers; ensures rebate claims data is in proper format
  • Maintains up-to-date knowledge of Model N Medicaid system and coordinates with IT and Model N tech support as necessary
  • Processes, reviews and validates all Medicaid rebate claims, ensuring all payments are made within the required timeframes, as stated in the contractual agreements
  • Utilizes DNA Software for State Preferred Drug Lists and dispute analysis

  • A Bachelor's degree required; relevant experience may be substituted for degree when appropriate
  • Ability to interact with various departments and levels internally and externally
  • Ability to work independently
  • Advanced PC skills required
  • Experience with Government Pricing Medicaid rebate system preferred (Model N, iMany)
  • Intermediate skills in Access and Showcase Query preferred
  • Intermediate skills in Microsoft Excel required
  • Knowledge of Medicaid Drug Rebate Program desirable
  • Requires a minimum of 3 years relevant experience
  • Strong analytical, quantitative, and qualitative analysis skills required
  • Strong attention to detail required
  • Strong organization and prioritization skills required

Novo Nordisk is an Equal Opportunity Employer - M/F/Veteran/Disability/Sexual Orientation/Gender Identity.

If you are interested in applying to Novo Nordisk and need special assistance or an accommodation to apply, please call us at 1-855-411-5290. This contact is for accommodation requests only and cannot be used to inquire about the status of applications.

Requisition ID: 59322BR
State/Provinces: Plainsboro
Job Category: Finance

Nearest Major Market: New Jersey

Job Segment: Accounts Payable, Purchasing, Medicaid, Claims, Finance, Government, Healthcare, Insurance