Company
Pharma
Director,BusinessServices(MedicaidOperations)
Neural analysis suggests this role is
optimal for Director candidates.
“Director, Business Services (Medicaid Operations). Skills: Medicaid Operations, Business Services, Stakeholder Management. Lead and define end-to-end Medicaid operations service delivery. Ensure high-quality outputs”
What You'll Achieve.
High-quality outputs; Client experience; Adherence to SLAs; Compliance with requirements
Industry & Context.
Data analysis; Root cause analysis
10–20% travel
What They're Looking For.
Must Have
Bachelor’s degree in Accounting, Finance, Business, or related field, 10+ years of experience in pharmaceutical industry, Deep exposure to Medicaid agreements and rebate operations, Proven leadership experience managing teams, Proven leadership experience managing client relationships, Experience in a complex, regulated environment, Medicaid rebates subject matter expertise, Medicaid contracting subject matter expertise, Claims-level validation processes subject matter expertise, Ability to lead operational transformation, Ability to drive process improvement, Ability to act as a change agent, Analytical skills with ability to work with large datasets, Ability to produce accurate, client-ready deliverables, Experience working in deadline-driven environments, Experience with multiple competing priorities, Solid understanding of compliance, Solid understanding of regulatory requirements, Solid understanding of industry best practices, Advanced proficiency in Microsoft Office, Experience using generative AI tools
Nice to Have
Generative AI tools to enhance productivity or decision-making strongly valued
What You'll Do.
Lead and define end-to-end Medicaid operations service delivery
Ensure high-quality outputs
Ensure client experience
Ensure consistent adherence to SLAs
Ensure compliance with requirements
Oversee review and approval of Medicaid rebate deliverables
Oversee review and approval of customer contracts
Oversee review and approval of data management activities
Serve as Medicaid subject matter expert
Establish best practices
Interpret regulatory changes
Ensure operational alignment
Drive operational excellence
Promote continuous improvement
Ensure compliance with SOC controls
Ensure compliance with internal policies
Ensure compliance with regulatory obligations
Ensure compliance with contractual obligations
Lead and develop a high-performing team
Foster accountability
Foster continuous professional growth
Manage strategic client relationships
Act as senior escalation point
Ensure resolution of complex inquiries
Ensure resolution of complex issues
Collaborate with cross-functional teams
Support system enhancements
Support process optimization
Support change management initiatives
Ensure successful adoption of new tools
Ensure successful adoption of new workflows
Ensure successful adoption of new operating models
How You'll Work.
Team & Collaboration
Cross-functional teams; Pricing teams; GTN teams; Product teams
Communication Scope
Stakeholder management
Process & Methodology
Change management
Full Job Description
## Accountabilities 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. 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
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