Drug Rebate Analyst

Hewlett Packard Enterprise – Enterprise Services (HPE ES) is a leading global technology services provider delivering out sourcing services and business solutions to clients around the world. HPE ES founded the information technology outsourcing industry nearly a half-century ago and today delivers one of the industry’s broadest portfolios of information technology, applications and business process outsourcing services available on the market today.

Job Description: Provides expertise to investigate and adjudicate claim characteristics that do not match policy provisions. Responds to provider appeals and meets with providers to resolve problems/issues. Provides directions for utilization review. Approves any remedial or recoupment actions associated with escalated claims. The ability to review drug criteria and develop and support preferred drug list. (PDL) Advises provider review councils, state officials and works with organized healthcare groups and associations on various medical issues related to insurance and healthcare programs.

Responsibilities:

  • Actively participates as a key member of the team, possibly in a team lead role.
  • Completes complex tasks and defined processes. Suggests creative solutions.
  • Multiple complex assignments are worked and completed simultaneously with minimal input from leadership.
  • Identifies, prioritizes and resolves most questions and issues independently. Answers questions of peers. Escalates more complex questions or issues appropriately.

Education and Experience Required:

High school education or equivalent; some college level education preferred.

Certified Pharmacy Technician or 1 year experience as a Pharmacy Technician in a retail environment

Knowledge and Skills:

The ability to review drug criteria and develop and support Preferred Drug List (PDL).

The ability to research all aspects of particular medications for drug class.

Experience in developing and defending policy decisions.

Ability to work directly with the provider community in various states who prescribe drugs to their recipients.

Ability to create and present clinical information in a formal setting.

Strong computer skills and ability to work in multiple software programs.

Researches dispute resolutions by working directly with the staff pharmacists and other drug rebate analysts.

Interactions when appropriate with drug manufacturers to finalize disputes.

Performs clerical tasks involved in an organization. These tasks may include, but are not limited to, general filing and records maintenance, preparing routine correspondence.

Strong computer skills with expert knowledge of Excel.


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