4 дня назад
Director, Contract Operations & Revenue Integrity
186 489 - 278 875$
Мэтч & Сопровод
Для мэтча с этой вакансией нужен Plus
Описание вакансии
Текст:
TL;DR
Director, Contract Operations & Revenue Integrity (Pharmaceutical Revenue Operations): Overseeing payer contract execution, rebate claim validation, payment processing, dispute resolution, and external audits with an accent on gross-to-net accuracy, revenue leakage prevention, and regulatory compliance. Focus on validating complex utilization data, recovering disputed funds, standardizing payer audit protocols, and maintaining SOX and government pricing controls.
Location: Remote within the United States
Salary: $186,489–$278,875 annually, plus incentive opportunity.
Company
is a pharmaceutical company developing and commercializing healthcare products and services.
What you will do
- Lead validation of commercial, managed care, PBM, Medicare, and Medicaid rebate claims.
- Authorize utilization data validation against contractual terms and formulary positioning.
- Oversee accurate, timely payment processing and maintain financial systems integrity.
- Identify overpayments, duplicate claims, and processing errors to reduce revenue leakage.
- Lead payer dispute resolution, reconciliations, settlement negotiations, and recovery tracking.
- Direct external payer audits and partner with Legal and Market Access on contractual remedies.
Requirements
- Bachelor’s degree in Finance, Accounting, Business, or Healthcare Administration required.
- 8+ years of experience in pharmaceutical contract operations, gross-to-net analytics, or revenue compliance.
- 4+ years of leadership experience managing validation analysts, auditors, or financial operations teams.
- Experience with payer contracts, rebate claims, financial validation, compliance, and auditing.
- Ability to work remotely while performing the role in the United States.
Nice to have
- MBA, CPA, CIA, or MS in Finance.
Culture & Benefits
- Comprehensive medical, dental, vision, and prescription drug coverage.
- Company-provided life, accidental death and dismemberment, and short- and long-term disability insurance.
- Tuition reimbursement and student loan assistance.
- Generous 401(k) match, flexible time off, paid holidays, and paid leave programs.
- Emphasis on accountability, strategic problem solving, impactful communication, respectful collaboration, and professional development.
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