Senior Manager, Medicaid Operations
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Job Location:
Boston, NH - USA
Monthly Salary:
$ 140000 - 187000
Posted on:
5 hours ago
Vacancies:
1 Vacancy
Job Summary
About This Role
The Senior Manager Medicaid Operations serves as a key leader within the Medicaid Operations team responsible for guiding critical operational analytical and compliance-focused activities to safeguard against revenue leakage. This role partners closely with cross-functional teamsincluding Legal Government Pricing Trade and Reimbursementas well as external stakeholders to identify investigate and resolve 340B duplicate discount issues. The Senior Manager will define and drive operational excellence to ensure full compliance with federal and state Medicaid program requirements.
The ideal candidate brings strong Medicaid Rebate operations expertise in-depth knowledge of the 340b program and a proven ability to lead operational processes. This role requires exceptional problemsolving skills sound judgment and the ability to lead teams through complex and evolving regulatory environments.
What Youll Do
340B Duplicate Discount Management
Lead the Medicaid teams efforts to develop processes and controls to identify investigate and resolve 340B duplicate discounts.
Leverage data to guide 340b inquiries and enhance operational controls.
Work with internal stakeholders to develop methodologies to detect potential duplicate discounts using state-claim-level data HRSA 340B registry and claims validation tools.
Partner with external stakeholders including state Medicaid agencies 340B covered entities and thirdparty administrators to determine the validity of disputes and ensure compliant resolution.
Serve as the subject matter expert on duplicate discount regulations HRSA guidance and industry best practices.
Medicaid Contract Operations & Compliance
Review Quarterly Medicaid and State Supplemental Rebate invoices to confirm accuracy timeliness and compliance with contract terms.
Drive process optimization initiatives to increase accuracy efficiency and transparency in Medicaid contract operations.
Support audits internal reviews and compliance assessments related to Medicaid and 340B programs.
Monitor emerging federal and state policy changes that impact Medicaid operations and guide the team in proactive adaptation.
Maintain dashboards analytical tools and reports that provide insights into Medicaid and 340B trends risks and operational performance.
Who You Are
You have a keen eye for detail and a robust ability to manage multiple priorities simultaneously. Your strong analytical skills enable you to interpret large data sets and compile evidence accelerating dispute resolutions.
Required Skills
Bachelors degree required; Advanced degree (MBA MPH etc.) preferred.
5 years of experience in Medicaid government pricing contract operations 340B program management or related pharmaceutical/healthcare fields.
Advanced Excel skills and knowledge of ModelN or a comparable rebate operation system.
Strong analytical skills with the ability to interpret large data sets and compile evidence to accelerate dispute resolutions.
Strong knowledge of Medicaid Drug Rebate Program (MDRP) 340B program regulations HRSA guidance and state Medicaid operations.
Demonstrated experience leading operational teams in a matrix reporting structure.
High attention to detail strong organizational skills and ability to manage multiple priorities.
Excellent communication influence and problem-solving skills.
Ability to synthesis complex information and clearly communicate to leadership stakeholders.
Additional Information
Base salary offered is determined through an analytical approach utilizing a combination of factors including but not limited to relevant skills & experience job location and internal equity.
Regular employees are eligible to receive both short term and long-term incentives including cash bonus and equity incentive opportunities designed to reward recent achievements and recognize your future potential based on individual business unit and company performance.
In addition to compensation Biogen offers a full and highly competitive range of benefits designed to support our employees and their families physical financial emotional and social well-being; including but not limited to:
- Medical Dental Vision & Life insurances
- Fitness & Wellness programs including a fitness reimbursement
- Short- and Long-Term Disability insurance
- A minimum of 15 days of paid vacation and an additional end-of-year shutdown time off (Dec 26-Dec 31)
- Up to 12 company paid holidays 3 paid days off for Personal Significance
- 80 hours of sick time per calendar year
- Paid Maternity and Parental Leave benefit
- 401(k) program participation with company matched contributions
- Employee stock purchase plan
- Tuition reimbursement of up to $10000 per calendar year
- Employee Resource Groups participation
Why Biogen
We are a global team with a commitment to excellence and a pioneering spirit. As a mid-sized biotechnology company we provide the stability and resources of a well-established business while fostering an environment where individual contributions make a significant impact. Our team encompasses some of the most talented and passionate achievers who have unparalleled opportunities for learning growth and expanding their skills. Above all we work together to deliver life-changing medicines with every role playing a vital part in our mission. Caring Deeply. Achieving Excellence. Changing Lives.
At Biogen we are committed to building on our culture of inclusion and belonging that reflects the communities where we operate and the patients we serve. We know that diverse backgrounds cultures and perspectives make us a stronger and more innovative company and we are focused on building teams where every employee feels empowered and inspired.Read onto learn more about our DE&I efforts.
All qualified applicants will receive consideration for employment without regard to sex gender identity or expression sexual orientation marital status race color national origin ancestry ethnicity religion age veteran status disability genetic information or any other basis protected by federal state or local law. Biogen is an E-Verify Employer in the United States.
Required Experience:
Senior Manager
Key Skills
- Employee Evaluation
- Continuous Improvement
- FDA Regulations
- Management Experience
- Process Improvement
- Profit & Loss
- Operations Management
- Project Management
- Strategic Planning
- Leadership Experience
- P&L Management
- Supervising Experience
About Company
Founded in 1978, Biogen is a leading biotechnology company that pioneers innovative science to deliver new medicines to transform patients lives and to create value for shareholders and our communities. We apply deep understanding of human biology and leverage different modalities, ... View more
