Director, Business Services (Medicaid Operations)
New
Based in the United StatesFull-TimeDirector
Salary150,000 - 195,000 USD per year
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Job Details
- Experience
- 10+ years
- Required Skills
- Microsoft OfficeComplianceStakeholder managementData managementGenerative AI
Requirements
- Bachelor’s degree in Accounting, Finance, Business, or a related field.
- 10+ years of experience in the pharmaceutical industry with deep exposure to Medicaid agreements and rebate operations.
- Proven leadership experience managing teams and client relationships in a complex, regulated environment.
- Strong subject matter expertise in Medicaid rebates, contracting, and claims-level validation processes.
- Demonstrated ability to lead operational transformation, drive process improvement, and act as a change agent.
- Strong analytical skills with the ability to work with large datasets and produce accurate, client-ready deliverables.
- Experience working in deadline-driven environments with multiple competing priorities.
- Solid understanding of compliance, regulatory requirements, and industry best practices.
- Advanced proficiency in Microsoft Office, particularly Excel, PowerPoint, and Word.
- Experience using generative AI tools to enhance productivity or decision-making is strongly valued.
- Excellent communication, organizational, and stakeholder management skills.
Responsibilities
- Lead and define end-to-end Medicaid operations service delivery, ensuring high-quality outputs, strong client experience, and consistent adherence to SLAs and compliance requirements.
- Oversee the review and approval of Medicaid rebate deliverables, customer contracts, and data management activities within internal systems.
- Serve as the Medicaid subject matter expert, establishing best practices, advising stakeholders, and interpreting regulatory changes to ensure operational alignment.
- Drive operational excellence by improving processes, increasing efficiency, and promoting automation and continuous improvement across Business Services.
- Ensure compliance with SOC controls, internal policies, and applicable regulatory and contractual obligations.
- Lead and develop a high-performing team, fostering accountability, engagement, and continuous professional growth.
- Manage strategic client relationships, acting as a senior escalation point and ensuring resolution of complex inquiries and issues.
- Collaborate with cross-functional teams (including pricing, GTN, and product) to support system enhancements, AI adoption, and process optimization.
- Support change management initiatives and ensure successful adoption of new tools, workflows, and operating models.
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