Drug Rebate Analyst - Remote West Virginia

Summary

Gainwell Technologies provides healthcare technology and Medicaid pharmacy operations solutions. The Drug Rebate Analyst supports Medicaid drug rebate operations by reviewing payments, invoices, claims, and utilization data, researching discrepancies, resolving disputes with manufacturers and other stakeholders, and tracking outstanding balances and workflow activities.

Responsibilities

• Review Medicaid drug rebate payments, invoices, and outstanding balances to identify discrepancies and support timely resolution
• Research disputed pharmaceutical utilization and claims data and develop accurate rebate dispute resolution recommendations
• Communicate and negotiate with drug manufacturers to resolve rebate disputes and follow up on unpaid or outstanding invoices
• Work with pharmacies, medical providers, and internal partners to verify claims information and obtain documentation needed to research and resolve discrepancies
• Track and prioritize dispute-resolution activities, manage assigned workflow queues, maintain accurate records, and complete required productivity reporting

Skills

• Strong analytical, research, and critical-thinking skills with the ability to investigate claims, utilization, payment, and invoice discrepancies
• Proficiency with Microsoft Office and electronic documentation/PDF applications, with the ability to work effectively in a paperless environment
• Strong organizational, written and verbal communication skills and the ability to maintain HIPAA confidentiality are required
• This is a **full-time remote position**, Monday through Friday, **8:00 AM – 5:00 PM Eastern Time**, and candidates must reside within the state of West Virginia
• This role is primarily work-from-home; however, employees may **occasionally be required to report to the Charleston, WV office based on business needs**. (Office located at **1201 Capital Greenbrier Street, Suite B, Charleston, WV 25311)
• Experience with **Medicaid Drug Rebates, pharmaceutical rebates, medical or pharmacy claims processing, pharmacy operations, medical billing, or a related healthcare environment** is highly preferred
• Experience with **PRIMS, SSRS Reports, Process Manager, or similar drug rebate, claims, reporting, or workflow systems** is preferred
• Bachelor's degree in business or a related field, or equivalent relevant professional experience, preferred

Qualifications

Must Haves

• Strong analytical, research, and critical-thinking skills with the ability to investigate claims, utilization, payment, and invoice discrepancies
• Proficiency with Microsoft Office and electronic documentation/PDF applications, with the ability to work effectively in a paperless environment
• strong organizational, written and verbal communication skills and the ability to maintain HIPAA confidentiality are required
• This is a **full-time remote position**, Monday through Friday, **8:00 AM – 5:00 PM Eastern Time**, and candidates must reside within the state of West Virginia
• This role is primarily work-from-home; however, employees may **occasionally be required to report to the Charleston, WV office based on business needs**. (Office located at **1201 Capital Greenbrier Street, Suite B, Charleston, WV 25311)

Nice to Haves

• Experience with **Medicaid Drug Rebates, pharmaceutical rebates, medical or pharmacy claims processing, pharmacy operations, medical billing, or a related healthcare environment** is highly preferred
• Experience with **PRIMS, SSRS Reports, Process Manager, or similar drug rebate, claims, reporting, or workflow systems** is preferred
• Bachelor's degree in business or a related field, or equivalent relevant professional experience, preferred

Benefits

• This role is primarily work-from-home
• Eligible employees have access to Gainwell benefits including medical, dental and vision coverage, a 401(k) retirement savings plan, paid time off, and wellness and financial programs, subject to eligibility.
• All salaried, full-time candidates are eligible for our generous, flexible vacation policy, a 401(k) employer match, comprehensive health benefits, and educational assistance.
• A variety of leadership and technical development academies to help build your skills and capabilities.
• Work flexibility, learning, and career development.