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State of Montana Drug Rebate Specialist (11728) in Helena, Montana

This position is responsible for administration and operation of the Pharmaceutical Manufacturers Rebate Program for Montana Medicaid, Medicaid Expansion, Physician Administered Drug (J-Code), Physician Administered Drug (J-Code) Expansion, Healthy Montana Kids and the Mental Health Services Plan (MHSP). This position is also responsible for reconciling historical pharmacy claim information in order to maximize manufacturer rebate for Montana Medicaid, Medicaid Expansion, Physician Administered Drug (J-Code), Physician Administered Drug (J-Code) Expansion, Healthy Montana Kids and the Mental Health Services Plan (MHSP). This position must apply Federal guidelines in the development and automation of a method to accumulate drug utilization, pricing, rebate information, generate invoices to manufacturers, receivables and account for funds collected, identify and resolve invoice and data errors, respond to manufacturers inquiries, resolve disputes, formulate edits to ensure accurate data from the claims processing system and evaluate the effectiveness of the program and assure compliance of the agency with applicable state and federal laws. Below are more detailed job duties: * Formulates and implements State and Federal rebate policy and procedure * Resolve manufacturer disputes * Develops, implements, and maintains automated drug rebate system * Prepare and present testimony for the Department on findings and decisions at administrative reviews and fair hearings. * Report collections and disputes. * Draft, negotiate, update, and monitor drug rebate contracts with pharmaceutical manufacturers in voluntary program. Must work with department personnel to ensure participating manufacturer's drugs have correct cost share assigned in accordance with rule and AMDD policy by accessing the pharmacy claims processing system to monitor claims. * Initiates and completes special projects for the pharmacy program that include the research and completion of surveys on the pharmacy program and additional information regarding the pharmacy programs in other states. * Serves as a key contact for drug manufacturers to verify formulary status and pricing information. * Responds to various provider inquiries. Physical and Environmental Demands:Travel both in state and out-of-state may be required as required by the programs managed. There is some stress involved in dealing with occasionally hostile groups and quick turn-around on projects. * Ability to work independently * Ability to interpret and apply laws, rules and regulations in the program * Ability to use personal computer to analyze spreadsheets, large paid claims files, and database applications for word processing * Ability to develop and direct diverse statewide programs in the medical field * Ability to evaluate program performance; design and implement corrective action plans * Ability to establish effective working relationship with staff, other managers, providers, other agency personnel, provider associations, recipients, recipient organizations, legislators, federal representatives, and the public * Ability to work with people and resolve issues * Ability to independently apply advanced planning and management principles for the purpose of extending existing and accepted practices, rules, and policies related to health services and reimbursement Minimum Qualifications: * Bachelor's Degree in a Human Services, Business, Public/Health Administration, or another related field. * 1 to 2 years of job-related work experience * High school graduate or post-secondary level training in accounting, financial management or experience in medical billing, medical records and coding may substitute for experience on a year-for-year basis. Equivalent progressively responsible experience can substitute for formal education on a case-by-case basis. * Experience with medical billing, medical coding systems, data analysis or other medical programs are preferred. For a copy of the full job description, please e-mail Kaley Argee To be considered for this position, please submit the following materials online through the State of Montana Careers site: * Cover Letter * Resume * Supplemental Question: o Please describe your experience with medical claims. (Please type responses in a Word document and attach to application. HELPFUL HINT: When attaching a document, you much check the “relevant document” box to ensure your attachments are uploading correctly to the specific application. Please do not attach more than requested. If you have more than 25 attachments in the system you will need to email these to: Failure to attach the required material will conclude in an incomplete application. You must also keep those relevant boxes checked once you submit your application; if you uncheck the box with an active application it will delete the attachment.) The State of Montana offers a comprehensive benefits package, which includes: • 15 paid vacation days • 12 sick days • 10 paid holidays a year To view State of Montana’s medical, dental, vision coverage, and other offerings, you can visit our Health Care and Benefits website at, This is an open until filled position, first initial review of applications will be May 19, 2021. /To be considered for any DPHHS Agency position, applicants must complete and submit their application online, as well as upload any required application materials. Successful applicant(s) are required to successfully pass all DPHHS specific background check(s) relevant to each position./ Job: Office/Administrative/Clerical* *Title: *Drug Rebate Specialist (11728) Location: Helena Requisition ID: 21141035