Drug Rebate Analyst - Remote West Virginia

Summary

Join Gainwell as a Drug Rebate Analyst and help support Medicaid pharmacy operations by reviewing manufacturer drug rebate payments, researching disputed claims and utilization, and resolving outstanding rebate balances. In this remote role, you will work with drug manufacturers, pharmacies, medical providers, and internal partners to investigate discrepancies, resolve rebate disputes, and support the accurate and timely collection of Medicaid drug rebate payments.

Your role in our mission

When joining Gainwell, you will:

• Review Medicaid drug rebate payments, invoices, and outstanding balances to identify discrepancies and support timely resolution.
• Research disputed pharmaceutical utilization and claims data and develop accurate rebate dispute resolution recommendations.
• Communicate and negotiate with drug manufacturers to resolve rebate disputes and follow up on unpaid or outstanding invoices.
• Work with pharmacies, medical providers, and internal partners to verify claims information and obtain documentation needed to research and resolve discrepancies.
• Track and prioritize dispute-resolution activities, manage assigned workflow queues, maintain accurate records, and complete required productivity reporting.

What we're looking for

• Experience with Medicaid Drug Rebates, pharmaceutical rebates, medical or pharmacy claims processing, pharmacy operations, medical billing, or a related healthcare environment is highly preferred.
• Strong analytical, research, and critical-thinking skills with the ability to investigate claims, utilization, payment, and invoice discrepancies.
• Experience with PRIMS, SSRS Reports, Process Manager, or similar drug rebate, claims, reporting, or workflow systems is preferred.
• Proficiency with Microsoft Office and electronic documentation/PDF applications, with the ability to work effectively in a paperless environment.
• Bachelor’s degree in business or a related field, or equivalent relevant professional experience, preferred; strong organizational, written and verbal communication skills and the ability to maintain HIPAA confidentiality are required.

What you should expect in this role

• This is a full-time remote position, Monday through Friday, 8:00 AM – 5:00 PM Eastern Time, and candidates must reside within the state of West Virginia.
• This role is primarily work-from-home; however, employees may occasionally be required to report to the Charleston, WV office based on business needs. (Office located at 1201 Capital Greenbrier Street, Suite B, Charleston, WV 25311).
• Regular interaction with drug manufacturers, pharmacies, medical providers, customers, and internal business partners to research and resolve rebate and claims-related matters.
• A highly electronic, paperless work environment requiring strong organization, attention to detail, independent follow-through, and the ability to manage multiple priorities while working remotely.
• Eligible employees have access to Gainwell benefits including medical, dental and vision coverage, a 401(k) retirement savings plan, paid time off, and wellness and financial programs, subject to eligibility.

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