The Rebate Clinical Program Manager optimizes clinical quality and cost-effectiveness of drug rebates by managing medical drug utilization and performing data analysis. They provide strategic recommendations to clients, conduct provider audits, and ensure accurate medical billing and rebate processing.
The Business Systems Analyst serves as a technical liaison between clients and IT staff to deliver and maintain pharmaceutical technology solutions. They are responsible for translating business needs into functional requirements, managing project plans, and ensuring the accuracy of system documentation.
The Account Manager is responsible for managing the full client life cycle, including onboarding, implementation, and ongoing relationship management. They lead cross-functional teams to ensure service performance, resolve operational issues, and drive client satisfaction and revenue growth.
The Documentation Specialist assists in the development and maintenance of health plan documents, policies, procedures, and standard operating procedures. They also perform quality checks on ID card orders and ensure departmental workflows are accurate and compliant.
The Software Engineer III develops, tests, and maintains complex software solutions while collaborating with business analysts to translate requirements into functional code. They also provide production support, mentor junior staff, and participate in code reviews to ensure high-quality software delivery.
Manage complex client accounts and the assigned book of business, developing strategic and financial plans that support client satisfaction, retention, growth, and profitability. Lead client relationships, renewals and negotiations, performance reviews, and cross-functional initiatives while monitoring service delivery and supporting sales and implementation activities.
Lead client services operations for an assigned PBM business segment, managing account teams, client relationships, service performance, budgets, projects, and escalations. Drive client satisfaction, retention, and growth while developing staff, improving processes, and coordinating with internal teams and sales leadership.
Process, prioritize, document, and finalize prior authorization requests according to client guidelines, turnaround times, and accuracy standards, including researching medication alternatives and obtaining missing information. Coordinate with members, providers, pharmacies, clinical pharmacists, and client teams to communicate request status and determinations while protecting confidential information.
The Appeals Clinical Specialist independently conducts clinical reviews of medical records and drug therapy to make benefit coverage determinations. They ensure all appeal processes comply with regulatory, accreditation, and organizational standards while supporting cost-effective pharmaceutical care.
Configure pharmacy, formulary, and benefit changes for assigned clients, managing change requests from intake and design through configuration and in-unit testing. Research claims issues, collaborate with clients and internal teams to clarify requirements, and deliver accurate, documented configurations on schedule.
The Formulary Administration Specialist participates in the design and validation of pharmacy benefit management plans and ensures accurate coding of plan information. They also provide comprehensive support to external clients regarding formulary change requests and maintain service levels according to corporate standards.
The Sales Director leads territory management by developing business relationships with brokers, consultants, and prospective clients to achieve sales targets. They work cross-functionally to manage the full sales cycle, including prospecting, pricing, contract negotiation, and client onboarding.
The Formulary Administration Pharmacist manages operational aspects of formulary set-up, including quality control, rule sets, and coding accuracy. They act as a subject matter expert to translate clinical strategies into operational implementation while ensuring compliance with regulatory requirements.
The Appeals Clinical Specialist independently conducts clinical reviews of medical records and medication requests to make benefit coverage determinations. This role ensures all appeal processes comply with regulatory, accreditation, and organizational standards while supporting cost-effective drug therapy.
The Account Manager is responsible for managing client relationships, ensuring customer satisfaction, and overseeing the operational aspects of client retention and new business implementation. They lead cross-functional teams to deliver project milestones, resolve service issues, and ensure compliance with client service agreements.
Conduct compliance audits of retail, mail order, and specialty pharmacies to ensure adherence to government regulations and contractual standards. Analyze pharmacy claims data to identify discrepancies, fraud, or abuse and process necessary adjustments.
The Regional Manager drives sales growth and profitability within an assigned territory by developing business relationships and executing complex sales strategies. They are responsible for identifying high-value leads, conducting product presentations, and managing the entire sales process from prospecting to contract closure.
The analyst tests and performs in-depth analysis of pharmacy and benefit configurations in a pre-production environment to ensure accuracy and adherence to business requirements. They also collaborate with internal teams and clients to validate benefit changes, identify discrepancies in claims adjudication, and document test results.
The Clinical Account Executive manages client relationships by implementing and optimizing clinical programs within PBM offerings. They provide expert clinical guidance, analyze performance data, and ensure alignment with client healthcare objectives.
The Account Manager is responsible for leading operational aspects of client servicing, including implementation, relationship management, and renewals. They ensure consistent customer satisfaction by managing client expectations, resolving adjudication issues, and delivering successful project outcomes.
The Clinical Account Executive manages client relationships by implementing and optimizing clinical programs within PBM offerings. They serve as the primary clinical point of contact, providing expert guidance and data-driven strategies to ensure client satisfaction and regulatory compliance.
Responsible for the execution of annual accreditation, clinical quality, and UR licensure assessment processes to maintain NCQA and URAC standards. Coordinates with internal partners and delegated entities to monitor compliance, perform audits, and implement quality improvement recommendations.
The Clinical Quality Pharmacist performs clinical audits of Prior Authorization and Appeals staff to ensure compliance with regulatory and accreditation standards. This role also involves creating quality reports, managing inter-rater reliability testing, and identifying opportunities for process improvement.
The Implementation Manager is responsible for managing the transition of new business into MedImpact by collaborating with internal teams and external clients. They ensure project deliverables meet service agreements, maintain high client satisfaction, and facilitate the successful delivery of revenue.
The Financial Analyst II supports the organization's FP&A, financial reporting, month-end close, budgeting, and forecasting processes. This role analyzes financial and operational data to produce reporting packages, dashboards, and financial models for leadership and internal stakeholders.
The Clinical Solutions Manager oversees the operational workflows for clinical products, including business analysis, implementation, and project management. They act as a subject matter expert and liaison between departments to ensure strategic initiatives meet corporate operational excellence and revenue goals.
The Clinical Account Executive manages client relationships by implementing and optimizing clinical programs within PBM offerings. They provide expert clinical guidance, analyze performance data, and collaborate with internal teams to ensure client satisfaction and strategic alignment.
The Principal, Business Intelligence Architect leads the design, implementation, and enhancement of BI solutions while serving as a subject matter expert for the Medicaid Fee-For-Service team. This role manages staff and collaborates with cross-functional stakeholders to translate complex business needs into scalable, high-quality data reporting solutions.
The Appeals and Grievances Coordinator I manages the intake, processing, and notification of appeal and grievance requests while ensuring compliance with regulatory standards. The role involves performing outreach, maintaining accurate documentation, and collaborating with internal and external clients to resolve issues within established turnaround times.
The Staff Accountant III performs advanced accounting functions, including preparing financial reports, analyzing trends, and managing key accounting functions like cash and investments. They also drive process improvement initiatives, mentor less experienced staff, and ensure compliance with GAAP and Sarbanes-Oxley requirements.
The Principal, Formulary Consulting is responsible for developing and executing strategies to optimize rebate yields and reduce drug spend through formulary management and contract alignment. They serve as a subject matter expert for internal and external stakeholders, leading formulary strategy and managing complex rebate modeling.
The Director is responsible for directing underwriting and economic strategy for complex trade and emerging market initiatives to support client value and EBITDA performance. This role leads cross-functional teams to develop financial models, evaluate program impacts, and ensure operational execution of pharmaceutical strategies.
The Principal is responsible for developing and managing rebate analytics strategies to deliver enterprise-wide value and pricing transformations. They will lead cross-functional teams, manage client and vendor relationships, and ensure the accuracy and timeliness of financial reporting.
The Director of Rebate Economics leads the development and operation of strategic analytics, financial performance, and pricing strategies for rebate outcomes. This role partners with executive leadership and cross-functional teams to implement innovative pricing structures and optimize enterprise financial performance.
The Manager of Trade Emerging Markets coordinates market event activities across Trade Relations to ensure pricing impacts are accurately understood and operationalized. This role also supports the management of emerging market products by tracking milestones, facilitating cross-functional alignment, and documenting key decisions.
The Clinical Account Executive II manages clinical projects and pharmacy coverage for state Medicaid agencies to optimize drug therapy quality and cost-effectiveness. The role also serves as a team lead, providing guidance to junior staff and coordinating clinical strategies to meet client service level agreements.
Provides strategic support to state clients and manages cross-functional teams to ensure compliance with agreement terms and program standards. Focuses on maintaining customer satisfaction, executing revenue growth, and overseeing operational delivery for Medicaid Fee-For-Service programs.
