Meridian

  • Finance Team Lead

    Job Location US-MI-Detroit
    Job ID
    2018-6919
    Category
    Pharmacy
    Business Line
    MRx
  • Overview

    Who we are:

    Meridian, a WellCare Company, is part of a national network of passionate leaders, achievers, and innovators dedicated to making a difference in the lives of our members, our providers and in the healthcare industry.

     

    We provide government-based health plans (Medicare, Medicaid, and the Health Insurance Marketplace) in Michigan, Illinois, Indiana, and Ohio. As a part of the WellCare Family of companies, we deliver healthcare excellence to millions of members nationwide.

     

    Our associates work hard, play hard, and give back. Meridian associates enjoy an exceptional experience and culture including special events, company sports teams, potlucks, Bagel Fridays, and volunteer opportunities.

     

    A Day in the Life of a Finance Team Lead: 

    This position will be responsible for the assisting the VP with oversight and administration of the Pharmacy Finance Team that manages pricing and rebase analysis; underwriting and maximum allowable cost (MAC) programs.

    Responsibilities

    • Provide analytical support/ assistance:
      • Develop methodologies and models to determine and report on pharmacy cost drivers, rebate opportunities, trends, anomalies, and root causes, along with the ability to determine expected duration of anomalies
      • Develop models to efficiently determine MAC price changes and develop defense of current pricing due to outside inquiries using available benchmarks
      • Develop and maintain the pharmacy re-price process and negotiations models
    • Manage and develop a team of analysts to perform core department functions
    • Perform data quality control functions; audit of all data reports prior to placement in production data base
    • Identify opportunities for overall pharmacy network improvements based on data analysis
    • Perform reporting and reconciliation of data for the pharmacy and Medicare divisions
    • Responsible for designing and developing databases and data warehouses. Recommend new data items, structures and / or technology including PC databases to support data management and reporting
    • Assist with preparing accounting interface for pharmacy recording and Part D reporting
    • Policy documentation of procedures in all areas
    • Adhoc reporting
    • Provide analytical support/ assistance to internal departments as well as for external entities and activities such as CMS, CDH, OFIR, National Committee for Quality Assurance (NCQA), URAC, or general accreditation and HEDIS

    Qualifications

    What you can bring to Meridian:

    • Bachelor’s degree in Business Administration, Economics, Health Care, Information Systems, Statistics, or other related field is required
    • Minimum of 1 year experience of data analysis in finance, PBM/healthcare or other related experience is required
    • Experience with pharmacy claims report generation, presentation and analysis
    • Experience in using PC-based software packages, including relational database systems, spreadsheets, word processing and statistical software
    • Experience with ad-hoc reporting tools
    • Experience working on team projects in the health care industry; experience with MAC Program administration is a plus
    • 2+ year(s) of top performance as a non-management associate during which leadership abilities were demonstrated is required (for internal applicants)

    What Meridian can offer you:

    • Our healthcare benefits include a variety of plans that are effective on the first day of employment for our new full-time team members
    • Meridian offers 401k matching that is above the national average
    • Opportunities for growth are abundant; full-time MHP employees are eligible for tuition reimbursement and all employees have access to a variety of training through Meridian University
    • Meridian Health Plan was named Detroit's #1 Fastest Growing Company by Crain's Magazine, so it is a great time to get involved with Meridian

     

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