Teva Sr Contract Compliance Analyst 

United States, New Jersey 

448909150

• Review Managed Care Contracts, Formularies, Utilization Management, and PA policies to identify formulary/contract non-compliant findings.
• Analyzes and resolves disputes with accounts involving contract interpretation, utilization management, and/or formulary positioning. Engages Managed Markets members as needed and other internal teams.
• If applicable accounts are in post-audit schedule, help Manager/AD conduct analysis on post-audit findings.
• Tracks and communicates recoverability rates and financials for data accuracy and reporting.
• Aids in the delivery of key information in support of rebate modeling, contract performance assessment, and financial analysis.
• Communicates financial impacts to key internal stakeholders such as Revenue Accounting and Gross to Net.
• Understands fundamental mechanics of claims validation, rebate systems, and outside formulary tools such as MMIT and FingerTip Formulary.

Education required: Bachelor’s degree with emphasis in Business, Finance, Accounting or related fields or equivalent combination of education, training and/or direct work related experience.

Education preferred: Masters preferred

Years of experience required: Thorough understanding of Managed Care contracting as it relates to formulary access and tier position; Industry understanding of step-edits, NDC blocks, prior authorizations, copay differentials, preferred and non-preferred status is a plus.
• Ability to articulate comprehensive understanding of contract terms and conditions
• Advanced understanding of pharmaceutical rebate flow and decision points
• Minimum 3-4 years’ experience in financial analysis.
• Minimum 2-3 years’ experience working with drug formularies
• Advanced Excel skills

Specific experience required: High level knowledge of drug formulary structure (PA, QL, Tiers, ST), understanding of Managed Care contracting as it relates to formulary access and tier position for biosimilars and pharmacy drugs (Medical Claims/Managed Care), and Pharmaceutical contract language. Ability to display and articulate comprehensive understanding of Medical/Managed Care Rebate agreements.

Specific experience preferred:
Brand pharmaceutical business, specifically in market access, rebate adjudication, formulary modeling.
• Negotiation and presentation skills
• Understanding of drug purchase discounts and interaction with Rx based rebates

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