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Vertex · 4 months ago

Government Pricing Compliance Senior Manager

Boston, MA

Full-time

Hybrid

Mid, Senior Level

$144K/yr - $216K/yr

4+ years exp

Vertex Pharmaceuticals Inc. is seeking a Senior Manager for Government Pricing within the US Market Access department. This role involves providing subject matter expertise for price reporting and compliance related to government programs, while collaborating across various internal and external stakeholders to ensure adherence to regulations and policies.

Computer Software

Responsibilities

Key contributor within the Government Pricing Team, with demonstrable knowledge and experience in government pricing calculations and reporting requirements including Medicaid, Medicare, 340B and FSS

Supports actionable strategic and tactical recommendations that enable Vertex to adapt rapidly and appropriately evolve for U.S. government payer practices, policies, relevant legislation, regulations, trends and other dynamics

Actively monitor government pricing regulations as they relate to payer, IDN, policy, competitor, and market conditions to inform critical decisions and potential impacts to reimbursement as well as Federal pricing helping shape future access strategies

Collaborates with Market Access Contracting, Legal and broader Commercial Business Partners on contract reviews, assessing contractual terms, Bona-Fide Service tests (BFSF), FMV, Class of Trade Assessment, and other Government Pricing analysis

Leads contract assessments of all BFSF tests, ensuring four-part tests is appropriately analyzed, interpreted and documented, the highest level of compliance

Ensures contractual obligations under the Federal Supply Schedule (FSS) contract are met, through continuous monitoring of obligations with Federal Acquisition Regulations (FARs) and the Veterans Health Care Act

Establishes and maintains policies, procedures, and standards in support of Sarbanes-Oxley (SOX) requirements, internal/external financial reporting processes, and government regulations and stays abreast of CMS Medicaid rules and guidance changes

Collaborate across all internal and external stakeholders (i.e., Market Access Strategy, Contract Operations, GTN, Accounting/Finance, US Public Affairs, Legal, Audit, Commercial leaders, and external Legal and consultants)

Qualification

Government PricingContract ReviewRegulatory ComplianceAnalytical SkillsPricing Policy ResearchMicrosoft ExcelTeam CollaborationCommunication SkillsTime ManagementAttention to Detail

Required

A Bachelor's degree in Business, Finance, Accounting or Public Policy, and/or equivalent working experience

4-6 years of experience in pharmaceutical/biotechnology industry or state agency, with experience in Government Pricing, Finance, or other related government payer/program administration experience

Strong knowledge/understanding of relevant pricing and drug contracting strategy development, government pricing methodologies, government and commercial customers, and associated distribution channels

Demonstrable knowledge of the current policies and guidelines that affect government programs, pricing and payment adjustments (e.g., Final Rule, Proposed Rule, Inflationary Reduction Act)

Experience with and passion for pricing policy research (qualitative and quantitative impact assessments)

Strong analytical skills to interpret complex data and market trends for FMV assessments

Must show a high level of proficiency with Microsoft Access, Excel, PowerPoint and Word

Experience reviewing commercial contracts, for entities such as Specialty Pharmacies and Distributors, Wholesalers, PBMs, GPOs, or Copay vendors, etc

Collaborator in an environment of openness and trust through teamwork

Executes with a level of high personal accountability

Attention to detail and a high degree of accuracy, necessary to ensure compliance with timelines, internal policies, laws and regulations

Strong verbal and written communication skills, time management, and organization

Track record of self-development

Applies experience, structured thinking, emerging knowledge, and trends to help solve problems logically

Preferred

An MBA or other related graduate-level degree is a plus

Systems knowledge of Model N or Revitas/Flex is a plus

Benefits

Inclusive market-leading benefits to meet our employees wherever they are in their career, financial, family and wellbeing journey while providing flexibility and resources to support their growth and aspirations.

Medical, dental and vision benefits

Generous paid time off (including a week-long company shutdown in the Summer and the Winter)

Educational assistance programs including student loan repayment

A generous commuting subsidy

Matching charitable donations

401(k)