Rebate Operations Manager

About the Role

The role is integral to SmithRx's mission to disrupt the expensive and inefficient Pharmacy Benefit Management sector. By leveraging cutting-edge technology, innovative cost-saving tools, and best-in-class customer service, SmithRx aims to transform the US healthcare system. The company's collaborative culture and commitment to integrity, courage, and teamwork inspire employees to strive for excellence.

As a Rebate Operations Manager at SmithRx, you will be part of a dynamic team dedicated to making a meaningful impact in the healthcare industry. Your day-to-day responsibilities will involve overseeing claims lifecycle and quality assurance, managing error resolution, and driving financial integrity and rate maintenance.

What You Will Do

• Oversee initial claims file submissions and conduct comprehensive QA summaries to identify potential fallouts before submission
• Manage rejections from external partners, perform root-cause analysis on data issues, and re-submit corrected claims to maximize capture
• Monitor and push for the billing of claims missed during initial windows due to vendor delays or data gaps
• Build and maintain master rate lists based on current formularies and utilization management
• Marry billed amounts back to rate lists to identify missing, incorrect, or inappropriately billed amounts
• Verify incoming payments against invoiced amounts and identify and dispute short-payments or missing funds
• Build out rebate performance reports to provide insights into rebate trends
• Run monthly pro-forma estimates of expected rebates to serve as a benchmark for actual collections
• Manage and optimize internal dashboards to provide slice-and-dice visibility into rebate trends for executive leadership and sales teams

What We Are Looking For

• Bachelor's Degree in Finance, Accounting, Data Analytics, Economics, or Business Administration
• Minimum of 2 years of direct experience with a GPO or similar rebate aggregators/aggregating platforms
• Proficiency in managing large data sets at the NDC-11 level
• Advanced Excel skills
• Strong understanding of the reconciliation loop connecting initial claims to invoices and invoices to actual cash received
• Proven ability to track stale billing and post-billing rejects through to resolution
• Proven knowledge of pharmacy benefit management practices, including utilization management and clinical program design

Nice to Have

• Experience with data visualization tools
• Knowledge of healthcare technology and digital health solutions
• Certification in data analytics or a related field

Benefits and Perks

• Opportunity to work with a rapidly growing, venture-backed health-tech company
• Collaborative and dynamic work environment
• Professional development and growth opportunities
• Competitive compensation package
• Comprehensive health insurance
• Remote work stipend
• Flexible paid time off

• Develop a strong understanding of rebate operations and data analytics to stand out in your application.
• Showcase your proficiency in Excel and ability to manage large data sets.
• Highlight any experience you have with pharmacy benefit management practices and healthcare technology.
• Be prepared to provide examples of how you have tracked and resolved stale billing and post-billing rejects in previous roles.
• Consider obtaining certification in data analytics or a related field to boost your candidacy.
• Research SmithRx's mission and values to demonstrate your alignment with the company's goals and culture.
• Prepare to discuss your experience with data visualization tools and how you can apply them to optimize internal dashboards.