A. WILLIAMS-THOMASON
Powder Springs,GA
Summary
Seasoned Medicaid Drug Rebate Manager with 18+ years of industry experience. Proven track record in optimizing rebate revenue and ensuring compliance with federal and state regulations. Expert in negotiating disputes resolution, managing relationships with clients and pharmaceutical companies, and utilizing analytics to maximize rebate recoveries. Servant leader with a focus on building high-performing teams and fostering a team culture built on collaboration, knowledge transfer and innovation.
Overview
22
22
years of professional experience
Work History
Senior Manager, Drug Rebate Operations
Conduent
11.2023 - Current
- Oversees end-to-end Medicaid drug rebate processes, including claim submission, invoice processing and reconciliation
- Ensures accurate billing and maximize recovery of billions of rebate dollars for state clients
- Staying abreast of all legislative and regulatory policies related to the Medicaid Drug Rebate Program and Covered Outpatient Drugs
- Building and maintaining strong relationships with key stakeholders, including manufacturers, pharmacies and state agencies
- Prepares accurate and timely financial reports for management and regulatory agencies
- Mentors junior staff members for skill development and career progression within the organization
Sr. Business Process Analyst
IQVIA
01.2022 - 05.2023
- Works with assigned states to retrieve and process Medicaid invoices each quarter while avoiding interest and penalties
- Evaluates Medicaid Rebates data by searching for trends and understanding financial terms of contract
- Analyze contracts and other documents, perform quality assurance checks on data, and communicate effectively both orally and in writing with state Drug Rebate Administrators and clients
- Ensured accurate and appropriate responses to disputes
- Validate appropriate data from internal and third-party systems and ensure appropriate course of action is being pursued
- Manage job completion and deadlines to ensure team meets SLAs and deliverables
- Led bi-weekly and quarterly calls to share dispute findings with the client
- Provides support to team members
- Assists with training project
Rebate Analysis Associate III
Conduent State Healthcare
01.2008 - 12.2021
- Primarily responsible for resolution of Medicaid Drug Rebate disputes between the State of Massachusetts and drug manufacturers
- Compare unit type discrepancies between Centers for Medicare & Medicaid Services and First Data Bank
- Able to convert NDC units to HCPC units
- Contact drug manufacturers to determine basis for disputes
- Provide claims information to drug manufacturers
- Examines claims level detail to detect outlier claims and possible reasons for rebate disputes
- Ensure outlier claims are corrected in rebate system prior to invoicing
- Perform collection activity for non-payment of rebates
- Assist with allocations of rebate payments
- Conduct pharmacy provider education
- Able to work both independently and in team environment
Certified Pharmacy Tech/DUR Coordinator
ACS State Healthcare
01.2003 - 01.2007
- Responsible for following clinical criteria and instructions to approve prior authorization request
- Evaluated and authorized approval and communicated decision for prior authorization pharmacy requests according to clinical guidelines established by the client
- Evaluated and authorized approval of prior authorization pharmacy requests from prescribers received by telephone and/or facsimile using client clinical criteria
- Determined appropriateness for medications and communicated decision to physicians, physician's office staff, medical management staff and/or pharmacists
- Communicated selected prior authorization criteria, pharmacy benefit coverage and formulary alternatives to physicians, physician's office staff, medical management staff and/or pharmacists
- Researched, resolved and documented prior authorization outcomes in pharmacy system
- Escalated requests to Pharmacist when request requires extensive clinical review or denial
- Researched, resolved and documented physician or client inquiries and grievances and provides verbal or written results to client, prescriber, provider and/or management
Education
Georgia Perimeter College
Decatur, GASkills
- Strategic Planning
- Team Leadership
- Teamwork and Collaboration
- Excellent Communication
Timeline
Senior Manager, Drug Rebate Operations
Conduent
11.2023 - Current
Sr. Business Process Analyst
IQVIA
01.2022 - 05.2023
Rebate Analysis Associate III
Conduent State Healthcare
01.2008 - 12.2021
Certified Pharmacy Tech/DUR Coordinator
ACS State Healthcare
01.2003 - 01.2007
Georgia Perimeter College
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