Director, Business Services (Medicaid Operations)

We are seeking a Director, Business Services for Medicaid Operations, to lead a critical area of our Business Services organization. In this role, you will serve as our Medicaid leader and subject matter expert, shaping how we deliver exceptional service, advance operational excellence, and bring industry-leading practices to our clients. You will play a highly visible leadership role—building strong partnerships across clients and internal teams, developing high-performing talent, and driving innovation, efficiency, and continuous improvement across the function. This role is fully remote.

Responsibilities

Service Delivery & Operational Excellence

• Own and develop best-in-class delivery processes and outputs that provide clients with a positive experience.
• Act as a driver of efficiency and a leader of change, championing best practices across the group.
• Direct the review and approval of Medicaid rebate deliverables, ensuring quality, accuracy, and compliance.
• Responsible for review and approval of the setup and maintenance of customer contracts and data management within Model N systems.
• Comply with all SOC controls and internal processes and procedures.

Medicaid Subject Matter Expertise & Regulatory Leadership

• Serve as the subject matter expert in Medicaid processing and contracting.
• Understand the impact of regulatory changes and educate stakeholders on those impacts.
• Drive rebate savings through deep understanding of Medicaid claims-level detail validations and resolving disputes with states.

Team Leadership & People Development

• Lead, coach, and develop a high-performing Medicaid operations team.
• Build team capability through clear goals, ongoing feedback, and development planning.
• Create an inclusive, globally connected team environment.
• Provide leadership through change, helping the team adapt to evolving needs.

Client Relationship Management

• Own and grow strategic client relationships, serving as the senior point of escalation.
• Respond to customer and client inquiries regarding processing status, reconciliation, and data discrepancies.

Cross-Functional Partnership & Innovation

• Collaborate with GP Pricing and GTN teams.
• Work with product teams to drive system enhancements, including adoption of AI and automation.

Qualifications

• Bachelor's degree in Accounting, Finance, Business, or related field.
• 10+ years of experience in the pharmaceutical industry with Medicaid agreements, including team leadership and client management.
• Proven people leadership experience.
• Demonstrated ability to lead through change and drive operational transformation.
• Experience working with Medicaid rebate systems and subject matter expertise in Medicaid rebates.
• Experience working in a mandated deadline environment.
• Ability to comprehend and apply complex government compliance requirements.
• High accuracy, attention to detail, and strong analytical skills.
• Technical ability to understand underlying data structures.
• Demonstrated experience using generative AI tools (e.g., ChatGPT, Copilot, Claude, Gemini).
• Advanced proficiency in Microsoft Office.
• 10-20% travel required.

Benefits

• Unlimited PTO for salaried employees.
• Comprehensive medical, dental, and vision coverage.
• Health Savings & Flexible Spending Accounts.
• 401(k) with company match.
• Volunteer Time Off (VTO).
• Life and pet insurance.
• Employee Assistance & Mental Health Programs.
• Professional coaching and career development.

The base salary for this position is $150,000 to $195,000.

About Model N

Model N is the leader in revenue optimization and compliance for pharmaceutical, medtech, and high-tech innovators. For more than 25 years, we have helped customers maximize revenue, streamline operations, and maintain compliance.

Equal Opportunity Statement

Model N values diversity and is an equal opportunity employer. All qualified applicants will receive consideration for employment without regard to race, religion, color, national origin, sex, sexual orientation, gender identity, age, disability, or veteran status. #LI-MN1