Specialist - Government Contracts - Medicaid

Facility:  Legal, Compliance and Audit
Location: 

Plainsboro, NJ, US

About the Department                                                                                                                                                 

At Novo Nordisk, our Strategy, 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’s short and long-term planning, the Strategy, Finance and Operations team works closely with the business 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, provide commercial insights & analytics, 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

This individual has the primary responsibility of processing and reconciling the Medicaid claims utilizing the Model N System. Responsible for preparing Medicaid analyses as required. Ensures NNI compliance with the Medicaid Drug Rebate Program (MDRP).

 

Relationships

This position reports to a manager in the Government Contracts & Operations group. Interacts with home office management regularly. External relationships include Centers for Medicaid and Medicare & State Medicaid agencies.

 

Essential Functions

  • Medicaid Processing

    • Ensures rebate claims data is in proper format. Identifies missing claims data and works with States in gathering and obtaining this data

    • Responsible for the timely and accurate processing and payment of Federal and State Medicaid Rebate Invoices. Reviews state utilization data for reasonableness. Prepares/reviews quarterly Medicaid, ADAP, SPAP (State Programs), and Supplemental Invoices and ensures compliance with the MDRP program guidelines

  • Data Analysis and Medicaid Reporting

    • Analyzes and ensures accuracy of state rebate formatted data for each level of processing. Identifies and analyzes performance trends and provides recommendations to management.

    • Responsible for data validation processes using (Excel, Access & Model N)

    • Reviews and analyzes contract terms and conditions. Ensures that data in Model N accurately reflects the contract terms

    • Assist internal and external customers with basic questions or problems arising with contracts

    • Prepares and provides standard reports (i.e., sales, rebate pricing, reconciliation) to home office management. These reports include sales and trending reports used by upper management for the purposes of claim approvals & strategic decision-making. Prepares and distributes quarterly dashboard reporting which includes high level insights into National Medicaid rebate trends and Gross to Net impact

  • Medicaid Rebate

    • Acts as company liaison, negotiating with state Medicaid agencies regarding dispute resolution with a third-party Consultant. Quantifies and accounts for dispute exposure

    • Stays up to date and applies knowledge of the Medicaid Rebate legislation including Federal, Supplemental, and individual state programs

    • 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. Liaises with FP&A to improve forecast methodologies

    • Develops and distributes quarterly analysis of Medicaid Rebate Liability

    • Ensures compliance with SARBOX requirements

    • Maintains and is an expert in operation of Model N Medicaid Rebate Processing systems

  • Medicaid Systems Maintenance/Contract Administration

    • Responsible for requesting checks and providing payment documentation to State partners

  • Utilizes and Enhances Rebate and Processing Technologies

    • Performs Medicaid system testing to ensure proper function

    • Recommends system and process improvements to ensure best in class Medicaid systems and processes

 

Physical Requirements

0-10% overnight travel required.

 

Novo Nordisk requires all employees, both Field and Office-based, to be fully vaccinated with a COVID-19 vaccine prior to the first date of employment. As required by applicable law, Novo Nordisk will consider requests for reasonable accommodation for those unable to be vaccinated. You will be required to upload an image of your COVID-19 vaccine card at the time of hire and/or on your first day of employment

 

Qualifications

  • A Bachelor’s degree required; relevant experience may be substituted for degree, when appropriate

  • A minimum of four (4) years related experience (financial analysis, Managed Care, Medicaid, and government price reporting) required

  • Analytical thinker capable of identifying both the depth and breadth of data required to accurately answer questions

  • Advanced Microsoft Excel skills required.

  • Knowledge of data validation processes using Excel, Access and Model N

  • Builds and maintains relationships with internal stakeholders to build an understanding of business objectives. Effective communicator, persuasive in support of conclusions

  • Intermediate proficiency in Access, Showcase Query desirable

  • Knowledge of Federal Government Contracting and Federal Government Pricing Calculations is desirable

  • Knowledge of the Medicaid Drug Rebate Program is desirable

  • Planner and forecaster savvy with recognizing trends, establishing forward progress, and focusing on the big picture as well as key details

  • Self-motivator who seeks to improve accuracy and efficiency of analytical work and business processes

We commit to an inclusive recruitment process and equality of opportunity for all our job applicants. 

 

At Novo Nordisk we recognize that it is no longer good enough to aspire to be the best company in the world. We need to aspire to be the best company for the world and we know that this is only possible with talented employees with diverse perspectives, backgrounds and cultures. We are therefore committed to creating an inclusive culture that celebrates the diversity of our employees, the patients we serve and communities we operate in. Together, we’re life changing.

 

Novo Nordisk is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, ethnicity, color, religion, sex, gender identity, sexual orientation, national origin, disability, protected veteran status or any other characteristic protected by local, state or federal laws, rules or regulations.

 

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.