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Technical Operations Specialist

Lansdale, PA

Posted: 02/10/2023 Job Number: 23086705

Job Description

Looking for two candidates to fill two similar, yet slightly different roles on the same team. Please see difference in job description.

#1 - PBC Contract Set Up and Maintenance.
  • Contract Eligibility research and resolution.
  • 340 Maintenance and Monitoring as extension with Integrichain.
  • Chargeback settlement communications with Customer as extension with Integrichain.
  • Pricing verification with 3PL, Wholesalers and Integrichain (to include meeting facilitation, Issue and Change management).
  • Rebate and Admin Fee Payment review and approval.
  • Amendment Management and Implementation support.

#2 - UBC Contract Set Up and Maintenance.
  • Plan Eligibility Maintenance and Audit.
  • Audit Support for Payment and Claims Reconciliation.
  • Formulary Validation.
  • Customer Issue Resolution as an extension of Integrichain.
  • Rebate and Admin Fee Payment review and approval.
  • Amendment Management and Implementation support.

Project Description:
  • General Contracting Lead:
    • Oversight and management of contract lifecycles.
    • Collaborate with internal/external teams to create, implement, monitor, and measure contracts, amendments, and notifications.
      • Note: 30-day E2E from receipt of signed contract to implementation in the system.
    • Review contracts (fertility, specialty, infliximab, contraception, SP GPO contraception, SP GPO, etc.).
    • Establish mailboxes, share drives, file share at both the Client and with IC as needed.
    • Manage documentation:
      • Work with Marc Rowe to ensure the migration of the signed and unsigned contracts and the rest of the Client's Share Drive folders and contents over to the Client.
      • Storage.
      • Naming conventions.
      • Permissions.
      • Total contracts: ~75 payor, ~150 provider.
    • Outline and train MA&AM on E2E process to guide the contracting collaboration between stakeholders.
    • Conduct quarterly reviews with IntegriChain.
    • Consider facilitating an annual review of contract performance with leaders from brands, operations, legal, account management, marketing, etc. To ensure that ROI is met.
    • Develop SOP and/or WI to reflect the role's processes.
  • IntegriChain Liaison:
    • Ensure mailboxes and file share are up and running.
    • Ensure manual tasks such as price protection and market share (e.G., ReUnite) calculations are documented in SOPs, validated, and can be supported.
    • Establish GoA if needed.
      • Determine if IC can accommodate tiered the Client's approvers.
    • Provide contracts to IC within 48 hours of signing.
      • Send to NewCoRebates@IntegriChain.Com.
      • Store on Share Drive.
    • Customer Membership and Eligibility Tasks:
      • Provide customer, membership, eligibility support.
      • Provide issue resolution support.
      • Approve credit / rebills for customer issues.
      • After contracts are signed reach out to the GPOs and their CME teams and introduce via email to IC to establish a relationship; then request their rosters go directly to IC; otherwise, you must forward them on a regular basis.
    • Chargeback and Wholesaler Tasks.
      • Determine effect of backorders/failure to supply on IC rebate payments; see Ken McDaid.
      • Provide issue resolution support.
      • Determine who approves chargeback errors; approve reconciliations; ensure the Client has decision rights on complex issues for compliance and audit purposes.
    • Contract Analyst Type Tasks (TBD).
      • Ensure government contracts set up and running appropriately (Medicaid, State, 340B, FSS, TriCare, VA, DoD).
      • Ensure IC is ready to go with market share, and other calculations; inform Compliance of work going on outside the system.
      • Review and approve contract set up term sheets created by IC including bundles and/or stacking.
      • Review and approve price protection.
      • Review and approve utilization and other customer data.
      • Review and approve payments and packages/documentation (within 48 hours).
    • Establish standing meetings, weekly then monthly then quarterly with IC.
    • Notify IC of any/all price changes right away.
  • Systems.
    • Support testing when needed of new/changed contracts, price protection; start w/basics CBs, Fees, REB, Scrubbing, then more complex items like MS, F2S; test SOPs.
    • Support contract related testing prior to and post Spin between stakeholders as needed on systems, apps, tools and processes.
    • Support IC, IT and other areas of the Client with testing of systems, apps, tools and processes as needed.
  • Data and Reporting.
    • Determine reporting needs across MA&AM team; coordinate with IC to either leverage existing reports, create new, or leverage analytics platforms.
    • Identify a single POC for reporting to avoid duplication, control number of users/licenses.
    • IC provides iCyte (wholesaler data) and SiSense analytics platforms.
      • IC provides 5 basic reports in the current SOW.
      • Note: data is deduped; not double paid.

This 12+ month position starts ASAP.

Please E-MAIL your resume (attachment to email) with rate and availability to Jennifer: jennifer@alphaconsulting.Com


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Jennifer Hernandez

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