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Medicaid Rebate Jobs in Rutherford, NJ (NOW HIRING)

Grunenthal

Compliance Officer, US

Morristown, NJ · On-site

$225K - $285K/yr

... Medicaid Drug Rebate Program and 340B considerations) * Demonstrated expertise in enterprise risk management, corporate compliance program requirements (incl., OIG expectation, DOJ guidance ...

Grunenthal

Compliance Officer, US

Morristown, NJ

$225K - $285K/yr

... Medicaid Drug Rebate Program and 340B considerations) * Demonstrated expertise in enterprise risk management, corporate compliance program requirements (incl., OIG expectation, DOJ guidance ...

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Showing results 21-25

All JobsMedicaid Rebate JobsMedicaid Rebate Jobs in Rutherford, NJ

Medicaid Rebate information

See Rutherford, NJ salary details

$19

$33

$51

How much do medicaid rebate jobs pay per hour?

As of Aug 16, 2026, the average hourly pay for medicaid rebate in Rutherford, NJ is $33.73, according to ZipRecruiter salary data. Most workers in this role earn between $26.20 and $37.98 per hour, depending on experience, location, and employer.

What is the difference between Medicaid Rebate vs Medicaid Claims Processor?

AspectMedicaid RebateMedicaid Claims Processor
Primary RoleManaging rebate calculations and compliance for pharmaceutical companiesProcessing and reviewing Medicaid claims for reimbursement
Required CredentialsPharmacy, healthcare, or pharmaceutical background; often with finance knowledgeHealthcare or medical billing certification; knowledge of Medicaid policies
Work EnvironmentPharmaceutical companies, healthcare compliance departmentsHospitals, clinics, Medicaid agencies

Medicaid Rebate specialists focus on managing rebate programs and ensuring compliance with regulations, while Medicaid Claims Processors handle the day-to-day processing of Medicaid claims for reimbursement. Both roles require healthcare knowledge but differ in their specific functions within the Medicaid industry.

What is a Medicaid Rebate specialist?

Medicaid Rebate specialists are professionals who manage and coordinate the Medicaid Drug Rebate Program (MDRP) for pharmaceutical manufacturers or state agencies. They ensure accurate calculation, submission, and reconciliation of rebate claims for prescription drugs covered by Medicaid. Their work involves compliance with government regulations, analysis of pricing data, and communication with state Medicaid programs to resolve discrepancies and ensure timely payments. These specialists play a crucial role in helping organizations comply with federal and state laws while optimizing rebate processes.

What skills and qualifications are needed to thrive as a Medicaid Rebate analyst?

To thrive as a Medicaid Rebate Analyst, you need strong analytical skills, attention to detail, and a solid understanding of Medicaid regulations, typically supported by a degree in finance, accounting, or a related field. Familiarity with Medicaid Drug Rebate Program (MDRP) systems, claims processing software, and data analysis tools like Excel is essential. Excellent communication, problem-solving abilities, and organizational skills help analysts manage complex data and collaborate with cross-functional teams. These skills ensure accurate rebate calculations, regulatory compliance, and effective resolution of discrepancies, which are critical for financial performance and legal adherence.

What are the main challenges faced by professionals working in Medicaid Rebate roles and how can they be addressed?

Professionals in Medicaid Rebate positions often encounter challenges related to navigating complex regulations, managing large volumes of data, and ensuring timely and accurate rebate submissions. Staying up-to-date with frequently changing state and federal guidelines is essential, as errors can result in financial penalties or compliance issues. To address these challenges, it is helpful to leverage robust data management systems, participate in ongoing training, and collaborate closely with cross-functional teams such as finance, legal, and IT to ensure all aspects of the rebate process are handled efficiently.

What cities near Rutherford, NJ are hiring for Medicaid Rebate jobs?

Cities near Rutherford, NJ with the most Medicaid Rebate job openings:

Medicaid Rebate jobs near you
Infographic showing various Medicaid Rebate job openings in Rutherford, NJ as of August 2026, with employment types broken down into 57% Full Time, 14% Temporary, and 29% Contract. Highlights an 86% In-person, and 14% Remote job distribution, with an average salary of $70,168 per year, or $33.7 per hour.

Pharmacist, UM-Formulary Oversight - Hybrid

EmblemHealth

New York, NY

$63.75 - $76.50/hr

Full-time

Posted 23 days ago

EmblemHealth rating

9.2

Company rating: 9.2 out of 10

Based on 6 frontline employees who took The Breakroom Quiz

21st of 308 rated insurance

Job description

Summary of Job

Responsible for setting Pharmacy UM criteria and decision tree oversight.  Review and maintain UM criteria (e.g., prior authorization (PA) and step therapy) for clinical appropriateness and alignment with P&T decisions.  Advise Operations team on vendor configuration for UM setup.  Partner with pharmacist Formulary, UM, and analytics teams to select annual formulary.  Partner with Finance and Pharmacy analytics to finalize disruption analysis and monitor medical drug rebates.  Provide formulary analysis for strategy opportunities, collaborate with Ops/Product strategy team to inform benefit design.  Advise pharmacy benefits manager (PBM) and operations team to implement formulary and prior authorization criteria.  Monitor key PGs, KPIs, and trends in utilization, authorization, and operations; report metrics to Formulary and UM Pharmacist Manager and Clinical Pharmacy Director.  Provide sound clinical judgment and subject matter expertise of State and Federal regulations to ensure compliance with regulatory and contractual obligations.

Responsibilities

  • Responsible for development, implementation, and maintenance of preferred formulary drug lists. 
  • Responsible for preferred drug lists for key clinical areas including primary care, pediatrics, dermatology, cardiology, ophthalmology, rheumatology, hematology/oncology, gastroenterology.  
  • Develop preferred formulary drug lists across all lines of business: Medicare Part D, Medicaid, Commercial, Healthcare Exchange. 
  • Evaluate and maintain formulary set-up based on clinical requirements, compliance with regulatory bodies, and P&T rules. 
  • Maintain clinical tools utilized by pharmacy services for purpose of remaining up to date and compliant with current pharmacy policies. 
  • Provide education on new formulary updates including quarterly formulary changes and annual 1/1 changes. 
  • Serve as subject matter expert for all escalated clinical formulary related issues as well as for all formulary related internal and external audits. 
  • Review weekly reports to identify trends and compliance.  
  • Work with IT to maintain preferred drug list updates. 
  • Identify and target prescribing outliers. 
  • Work with actuary to determine cost saving alternatives for preferred drug list.  
  • Manage the Pharmacy & Therapeutic Committee/Formulary Management, including Step-Protocol Review, NonFormulary Review, Subcommittee Management (Meetings/minutes), Drug Reviews, and Updates and Drug Policies, for all medications. 
  • Report formulary compliance to senior leadership. 
  • Other duties/projects as assigned

Qualifications

  • Doctor of Pharmacy degree 
  • PGY-1 or PGY-2 In Ambulatory Care, Geriatrics, Internal Medicine, or Managed Care  (Preferred) 
  • Registered Pharmacist: Registered Pharmacist license  (Requred)
  • 10 - 12+ years of relevant experience  (Requred) 
  • Residency or 5 years' clinical experience  (Preferred) 
  • Knowledge of formulary utilization management techniques  (Requred) 
  • Knowledge of pharmaceuticals and disease states to provide advice and consultation to providers and members and recommend changes to the formulary  (Requred) 
  • Possess research and analytical skills sufficient to provide problem resolution and consultation to providers  (Requred) 
  • Excellent verbal and written communication skills sufficient to prepare own correspondence and interact with members and providers in provision of advice and guidelines  (Requred)
Additional Information
  • Requisition ID: 1000003266
  • Hiring Range: $92,880-$178,200

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