Director / Senior Director, Medicaid Operations & Automation

Teva Pharmaceutical Industries Ltd

  • Parsippany, NJ
  • 3 days ago
  • $221,850–$258,825 Per Year
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Skills

  • Adjudicationunmatched
  • Analysis Skillsunmatched
  • Artificial Intelligence (AI)unmatched
  • Automationunmatched
  • Best Practicesunmatched
  • Biotech and Pharmaceuticalunmatched
  • Budgetingunmatched
  • Career Developmentunmatched
  • Centers for Medicare and Medicaid Services (CMS)unmatched
  • Change Managementunmatched
  • Claims Processingunmatched
  • Communication Skillsunmatched
  • Compensation and Benefitsunmatched
  • Continuous Improvementunmatched
  • Corrective Actionunmatched
  • Cross-Functionalunmatched
  • Data Analysisunmatched
  • Data Processingunmatched
  • Data Qualityunmatched
  • Data Scienceunmatched
  • Equal Employment Opportunity (EEO)unmatched
  • Financeunmatched
  • Forecastingunmatched
  • Governmentunmatched
  • Health Insuranceunmatched
  • Hospitalunmatched
  • Immunologyunmatched
  • Information Technology & Information Systemsunmatched
  • Leadershipunmatched
  • Legalunmatched
  • Life Insuranceunmatched
  • Maintain Complianceunmatched
  • Medicaidunmatched
  • Medical Conditionsunmatched
  • Medical Geneticsunmatched
  • Medicineunmatched
  • Mentoringunmatched
  • Militaryunmatched
  • Multitaskingunmatched
  • Neuroscienceunmatched
  • Operational Supportunmatched
  • Physical Therapyunmatched
  • Prescription Drugsunmatched
  • Pricingunmatched
  • Problem Solving Skillsunmatched
  • Process Improvementunmatched
  • Project Engineeringunmatched
  • Project/Program Managementunmatched
  • Regulationsunmatched
  • Regulatory Complianceunmatched
  • Regulatory Requirementsunmatched
  • Reporting Dashboardsunmatched
  • Resume Searchunmatched
  • Revenue Managementunmatched
  • Stock Purchase Plansunmatched
  • Strategic Planningunmatched
  • Team Lead/Managerunmatched
  • Team Playerunmatched
  • Technical Supportunmatched
  • Time Managementunmatched
  • Training Programunmatched
  • Training/Teachingunmatched
  • Trend Analysisunmatched
  • Tuition Feesunmatched

Description

We Are Teva

We're Teva, a leading innovative biopharmaceutical company, enabled by a world-class generics business. Whether it's innovating in the fields of neuroscience and immunology or delivering high-quality medicine worldwide, we're dedicated to addressing patients' needs now and in the future. Here, you will be part of a high-performing, inclusive culture that values fresh thinking and collaboration. You''ll have the room to grow, the flexibility to balance life with work, and the opportunity to better health worldwide, together.

Our Team, Your Impact

As Director / Sr Director of Medicaid Revenue Optimization & Automation, you will lead the transformation of Medicaid rebate operations by leveraging advanced technology, process automation, and data-driven strategies. Your mission is to drive operational excellence, eliminate revenue leakage, and ensure seamless dispute resolution, with a strategic focus on optimizing both generic and branded pharmaceutical portfolio operations. You will ensure that all assigned State Medicaid rebate programs fully comply with CMS and other regulatory requirements, and that all program activities are actively monitored, well-staffed, and effectively communicated across the organization.

How You'll Spend Your Day

  • Regulatory Compliance & Program Oversight:

Ensure each assigned State's Medicaid rebate program adheres to all CMS and applicable federal/state requirements. Actively monitor federal and supplemental rebate programs, maintain appropriate staffing levels, and oversee comprehensive training for Medicaid analysts.

  • Technology-Driven Process Leadership:

Champion the adoption of cutting-edge automation tools (AI, Bots) to streamline Medicaid rebate processing, data validation, and reporting. Continuously assess and implement digital solutions to enhance accuracy, speed, and scalability, including the use of Model N's Flex system for Medicaid adjudications.

  • Project Management & Innovation:

Lead cross-functional projects to re-engineer Medicaid processing workflows, integrating best practices in project management to deliver measurable improvements in cycle time, compliance, and cost efficiency. Foster a culture of innovation and continuous improvement by identifying emerging opportunities and piloting new approaches to enhance operational performance.

  • Revenue Integrity & Leakage Prevention:

Design and implement robust controls and analytics to proactively identify and prevent revenue leakage across all Medicaid transactions. Develop dashboards and exception reporting to monitor trends, root causes, and corrective actions.

  • Strategic Dispute Resolution:

Oversee the end-to-end dispute management process, utilizing advanced analytics and automation to resolve claim discrepancies efficiently. Collaborate with state agencies and internal teams to ensure timely, data-backed resolutions and minimize outstanding balances.

  • Effective Medicaid Operations:

Support the adjudication, validation, and dispute resolution of Medicaid rebates for both generic and branded pharmaceutical products, with increased attention to the complexities and compliance requirements of branded products. Ensure all claim processing and dispute activities are executed with precision, in alignment with regulatory standards and internal controls, while collaborating with relevant teams to address product-specific issues as they arise.

  • Stakeholder Alignment & Engagement:

Maintain close alignment with internal and external stakeholders, including state agencies, finance, value & access, IT, and compliance, to ensure seamless Medicaid operations. Stay continuously informed on all relevant government legislation, program guidance, and any new contracts or amendments, promptly updating processes and communicating changes. Facilitate clear, timely communication and collaborative problem-solving to support compliance and operational excellence.

  • Training, People Development & Collaborative Culture:

Lead comprehensive training and development programs to ensure team members possess the latest knowledge and skills in Medicaid rebate adjudication, claim validation, and dispute resolution. Champion a culture of continuous learning, open communication, and mutual respect, encouraging team members to share ideas, raise concerns, and collaborate freely. Promote professional growth and cross-training, empowering staff to adapt to evolving processes and technologies while supporting each other's success.

  • Team Leadership & Management:

Manage and mentor a large team of 10+ professionals, fostering a high-performance culture focused on accountability, collaboration, and results. Provide strategic direction, performance feedback, and career development opportunities to ensure team engagement and retention.

  • Budget & Financial Forecasting:

Drive continuous improvement initiatives and maintain accountability for all Medicaid rebate budget and financial forecasting activities.

Your Skills and Experience

Bachelor's or Master's degree (preferred) in Business, Finance, Data Science, Information Systems, or related field.

  • 10+ years of biopharmaceutical pricing and contracting experience with 7+ years of Medicaid rebate or pharmaceutical revenue management experience, with proven leadership in process automation and technology adoption.
  • Demonstrated expertise in project management, including leading cross-functional initiatives and driving change management to implement new technologies and optimize processes.
  • Strong background in process automation (AI, Bots) and process optimization, with a track record of delivering measurable improvements in efficiency, accuracy, and compliance.
  • Proven track record of innovation in developing and implementing forward-thinking solutions that enhance operational performance and drive strategic value.
  • Advanced proficiency with Medicaid adjudication platforms (Model N, Flex, or similar), and data analytics tools.
  • Excellent analytical, problem-solving, and communication skills, with the ability to manage multiple priorities and adapt to evolving regulatory and business environments.
  • Experience in both generic and branded pharmaceutical segments preferred.

Salary Range

The annual starting salary for this position is between $221,850-258,825 annually. Factors which may affect starting salary within this range and level of role may include geography/market, skills, education, experience and other qualifications of the successful candidate.

How We'll Take Care of You

We offer a competitive benefits package, including:

  • Comprehensive Health Insurance: Medical, Dental, Vision, and Prescription coverage starting on the first day of employment, providing the employee enrolls.
  • Retirement Savings: 401(k) with employer match, up to 6% and an annual 3.75% Defined Contribution to the 401k plan.
  • Time Off: Paid Time Off including vacation, sick/safe time, caretaker time and holidays.
  • Life and Disability Protection: Company paid Life and Disability insurance.
  • Additional benefits include, but are not limited to, Employee Assistance Program, Employee Stock Purchase Plan, Tuition Assistance, Flexible Spending Accounts, Health Savings Account, Life Style Spending Account, Volunteer Time Off, Paid Parental Leave, if eligible , Family Building Benefits, Virtual Physical Therapy, Accident, Critical Illness and Hospital Indemnity Insurances, Identity Theft Protection, Legal Plan, Voluntary Life Insurance and Long Term Disability and more.

The total compensation may also include restricted stock units and discretionary awards, depending on the position offered. Details of participation in these benefit plans will be provided if an employee receives an offer of employment.

Already Working @Teva?

Make sure to apply through our internal career site on Twist-your one-stop shop for career development

Teva's Equal Employment Opportunity Commitment

Teva Pharmaceuticals is committed to equal opportunity in employment. It is Teva''s policy that equal employment opportunity be provided without regard to age, race, creed, color, religion, sex, disability, pregnancy, medical condition, genetic information, marital status, sexual orientation, gender identity or expression, ancestry, national or ethnic origin, citizenship status, military status or status as a disabled or protected veteran, or any legally recognized status entitled to protection under applicable federal, state, or local laws.

Please advise us of any accommodations needed to support you throughout the recruitment and selection process. All accommodation information provided will be treated as confidential and used only for the purpose of providing an accessible candidate experience. Request a reasonable accommodation by sending an email to AskHR@tevapharm.com with the nature of your request and your contact information. Only inquiries concerning a request for a reasonable accommodation will be responded to from this email address.

Important notice to Employment Agencies - Please Read Carefully

Teva Pharmaceuticals USA does not accept unsolicited assistance from agencies for employment opportunities. All CVs / resumes submitted by search firms to any employee at our company without a valid written search agreement in place for this position will be deemed the sole property of our company. No fee will be paid in the event a candidate is hired by our company as a result of an agency referral where no pre-existing agreement is in place. Where agency agreements are in place, introductions are position specific. Please, no phone calls or emails.

Numbers & Facts

LocationParsippany, NJ
Salary$221,850–$258,825 Per Year

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