Medicaid Analyst

Riparian MSBPO Analyst Job Description

Riparian LLC is a Life-Sciences consulting, managed services, and technology firm. Healthcare is a transforming industry due to legislative and regulatory demands, technology challenges, and societal trends. Our mission is to empower life sciences contracting & pricing teams through comprehensive solutions delivering efficiency, clarity, and accelerated insights.

Our professionals have deep healthcare industry knowledge and expertise. This high performing team helps clients define their information strategy, architecture and governance, derive greater value from business intelligence and analytics and implement enterprise content and data management solutions which enable business insights, reduce cost and complexity, increase trust and integrity, and improve operational effectiveness.

We have a team of 60+ experienced professionals with a diverse range of background and skills. Riparian is looking for entry level Analysts to join our rapidly growing Managed Services & Business Process Outsourcing (“MSBPO”) team in Johnson City, TN.

Role and responsibilities:

As an Analyst on our team, you will work in a collaborative and supportive environment to create insights and value for clients. Team members are self-motivated and demonstrate flexibility to assist on a variety of tasks. Following are generalized requirements and tasks associated with the MSBPO Analyst role:

Development of Subject Matter Expertise

• Develop knowledge of government programs with an opportunity to develop deep expertise.


• Develop knowledge of commercial contracting and rebate and fees adjudication.


• Ability to read, research and understand guidance from Government and other agencies while retaining, applying, and growing your knowledge base.


• Stay current on industry trends as it relates to multiple service areas including but not limited to Pharmaceutical Pricing Compendium, Medicaid Rebates, State Program Contracting, Government Pricing Calculations, Class of Trade Assignment, 340B Covered Entity Eligibility, State Prescription Drug Price Transparency Reporting, Utilization and Sales-based Commercial Rebating and Contract Administration for Federal and State Programs as well as with Commercial Entities like Managed Care and Pharmacy Benefit Managers.


• Ability to follow and assist in developing Policy and Procedures for defined Service Areas.

Customer Service and Support

• Provide support for a varied client mix, including small, medium, and large pharmaceutical manufacturers.


• Ability to communicate with state government employees, third-party processors, Federal Agencies, commercial plans, or legal firms.


• Identify and address client needs: build relationships with clients; develop an awareness of Riparian services; approach client in an organized manner; deliver clear requests for information; demonstrate flexibility in prioritizing and completing tasks; communicate potential conflicts to a supervisor.


• Provide exceptional customer service and ongoing client relationships with excellent communication skills.

Analytical Mindset, Timeliness and Attention to Detail

• Identify, analyze, and solve data or process problems.


• Detect outliers in data and research to identify the cause of the anomaly.


• Setting up variance thresholds, determining reasonability of results.


• Prepare monthly and quarterly pricing and rebate deliveries by defined timelines.


• Reviewing contract terms or formulary positioning to determine proper rebate application.


• High accuracy rate and compliance with applicable legal requirements and policy and procedures serving as the foundation of the SOC controls and compliance.


• Reconciliation of payments or other finance functions such as reconciliation of data to the G/L.


• Assistance in reviewing client invoices for accuracy against Statement of Work.

Technical Skills in Software, Analysis and Reporting

• Proficiency in Microsoft Outlook, Excel, Word, and PowerPoint.


• Adaptability and proficiency in internal and leading industry software, including aspects such as set-up, maintenance, and on-going workflows.


• Support to ongoing process and system development, especially in times of evolving government and commercial program changes.


• Familiarity with database structures and ability to understand underlying tables.


• Interpret and analyze large datasets to develop analytics / solutions to support business needs.


• Prepare routine and ad hoc analysis, presentations, and assessment reports by collecting, analyzing, and summarizing information.

Adaptability

• Interact with end users to understand and document business and functional requirements for new or complex projects.


• Shift between Service Areas, tasks, or clients in a fast-paced environment.


• Flexible and adaptive to changing business requirements and processes.


• Team player willing to handle routine tasks such as data entry, ordering supplies or as assigned.

Interpersonal

• Collaborate and contribute as a team member: understand personal and team roles; contribute to a positive working environment by building solid relationships with team members; proactively seek guidance, clarification, and feedback.

Qualifications:

Ideal candidates will have a strong financial background based on a combination of education, experience, or both. Background in healthcare, pharmaceuticals or Life Sciences is a plus. Competency with data analysis tools, client service experience, understanding of pricing strategy / methodologies, and an ability to rapidly learn and apply new concepts.

• Bachelor or master's degree in Healthcare, Accounting/ Finance or Technology related field


• Strong record of leadership in an academic, professional, or extracurricular setting


• Understanding of defined Service Areas, including Commercial Contract Administration and rebate and fees adjudication, Medicaid contracting, and rebate processing or Government Pricing Calculations is a plus.


• Ability to prioritize concurrent project responsibilities


• High accuracy rate and attention to detail


• High degree of analytical and quantitative problem-solving skills


• Experience working with large data sets or proficiency with data tools such as MS Excel is required. Experience with data tools such as SQL or MS Access is a plus.


• Experience working with data analytical or data visualization tools such as Tableau and QlikView is a plus


• Effective management of multiple client assignments, from planning through completion


• Communicate effectively in written and verbal formats to various audiences in a professional business environment