Consultant POS Rebates Ops

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Job Description
This position will support the POS Rebates program, it's
clients and the POS Rebate Manager. This position will
also support activities related to Project IBEX.

Support POS Rebates operations, processes and client
implementations. Support POS Rebates Team.

Serve as backup subject matter expert on the POS
Rebates program. Provide inquiry support for account
teams, client underwriting, legal, internal audit, client audit
and clients.

Support issues and program enhancements to resolution.
Present to account teams and clients on the product and
value proposition.

Support POS Rebates quarterly underwriting rate, NDC
load and invoice-to-POS Rebates achievement audits, and
analysis. Support quarterly POS Rebate client analysis,
statement generation confirmation and rate/forecast, and
modulator adjustment activities. Assist in coordinating and
documenting business requirements for product
enhancement. Develop and document business
requirements and operational specifications. Help provide
and validate client reporting. This position will have primary responsibility to provide formulary research support to Rebate Invoicing and Clinical Operations for the purpose of researching and evaluating client formulary positioning to determine rebate eligibility for POS Rebate clients.

Perform detailed analysis at NDC level to reconcile and
perform quality checks on POS Rebate rates, PA and Step
Therapy flag parameters, and pharmacy exclusions. Assist
in assessing any client or member issues and service
warranties as needed.

Support formulary research on a monthly & quarterly basis
on drugs on each company/client formulary to determine
relative to the appropriate Manufacturer contract its
eligibility for rebate invoicing for that period.

Conduct specific formulary research to support rebate and
forecasting teams during the contract negotiating process,
rebate invoicing team as questions are identified during the invoicing process, rebate audit team as questions arise on audits by Manufacturers, and Clinical Managers and Clients.

Support Services as they work with clients in the
development of formularies.

Required Qualifications
6+ months of corporate work experience

COVID Requirements
CVS Health requires its Colleagues to be fully vaccinated against COVID-19 (including any booster shots if required), where allowable under the law, unless they are approved for a reasonable accommodation based on disability, medical condition, or religious belief that prevents them from being vaccinated.

If you are vaccinated, you are required to have received at least one COVID-19 shot prior to your first day of employment and to provide proof of your vaccination status within the first 10 days of your employment. For the two COVID-19 shot regimen, you will be required to provide proof of your second COVID-19 shot within the first 45 days of your employment. In some states and roles, you may be required to provide proof of full vaccination before you can begin to actively work. Failure to provide timely proof of your COVID-19 vaccination status will result in the termination of your employment with CVS Health.

If you are unable to be fully vaccinated due to disability, medical condition, or religious belief, you will be required to apply for a reasonable accommodation within the first 10 days of your employment in order to remain employed with CVS Health. As a part of this process, you will be required to provide information or documentation about the reason you cannot be vaccinated. In some states and roles, you may be required to have an approved reasonable accommodation before you can begin to actively work. If your request for an accommodation is not approved, then your employment may be terminated.

Preferred Qualifications
Prefer cross-functional knowledge on adjudication
platforms, EDW, finance systems and Rebate Payment
System, formulary research FRS system and formulary
systems. Prefer strong knowledge of:

• Plan design and relation to formulary. Includes PA, copay
structure and tiering.
• Detailed claims elements including cost elements.
• Formulary concepts and drivers of rebate eligibility.
• Knowledge of rebate research and invoicing processes.
• Systems development life cycle and IT processes.
• Ability to analyze large data sets and evaluate trends and
key root causes of claim issues.
• Working knowledge of client and or pharmaceutical
contracts.
• Proficient in MS Excel. Visio/flowcharting and data query
tools experience desired.
• Strong project management skills desired. Attention to
detail and analytical abilities required.
• Ability to work closely with key business counterparts to
facilitate business solutions and to manage/influence
individuals in cross functional teams.
• Excellent verbal and written communication skills.
• Ability to interpret business rules into technical
requirements.
•Ability to understand financial models and practices

Education
Bachelors Degree required

Business Overview
At CVS Health, we are joined in a common purpose: helping people on their path to better health. We are working to transform health care through innovations that make quality care more accessible, easier to use, less expensive and patient-focused. Working together and organizing around the individual, we are pioneering a new approach to total health that puts people at the heart.

We strive to promote and sustain a culture of diversity, inclusion and belonging every day. CVS Health is an equal opportunity and affirmative action employer. We do not discriminate in recruiting, hiring or promotion based on race, ethnicity, sex/gender, sexual orientation, gender identity or expression, age, disability or protected veteran status or on any other basis or characteristic prohibited by applicable federal, state, or local law. We proudly support and encourage people with military experience (active, veterans, reservists and National Guard) as well as military spouses to apply for CVS Health job opportunities.