Vertex · 4 hours ago
Manager of Chargeback Operations
Boston, MA
Full-time
Hybrid
Mid, Senior Level
$129K/yr - $193K/yr
8+ years expVertex is a global biotechnology company that invests in scientific innovation. They are seeking a Manager of Chargeback Operations to oversee membership management and ensure compliance with industry regulations while collaborating with various teams to optimize processes and drive operational efficiency.
Computer Software
Responsibilities
Play a critical role in managing membership for 340B, GPOs and additional strategies in multiple therapeutic areas, working cross-functionally with 3PL, Trade & Distribution, Accounting, and DTE, etc. to develop policies, efficient processes, system requirements, and departmental SOPs
Partner with Government Pricing, Contract Operations, Payer Accounts and Legal, etc. to provide key insights during contracting strategy design, contract development, negotiation, and operationalizing strategies
Stay current with all promulgated and proposed federal regulations that could potentially impact chargeback and/or rebate adjudications, strategically assessing and communicating potential impact to current and/or future processes
Oversee and optimize the membership management process, ensuring accuracy and compliance with industry regulations and internal SOX controls. Lead for SOX-related, internal, and external audits
Knowledge and understanding of the 340B Drug Discount Program and membership eligibility requirements to safeguard against diversion, duplicate discounts, and incorrect chargebacks submissions
Support internal assessments of contract pharmacy arrangements in alignment with 340B Contract Pharmacy Policy terms and conditions
Analyze purchase data and investigate chargeback anomalies related to eligibility, NDCs, contract pharmacies, and/or potential duplicate discounts
Responsible for contract operationalization, including Model N/Revitas contract set-up, membership management, and customer payment administration. Establish processes to ensure consistent translation of contract terms into operational solutions
Manage contract and membership compliance, including timely verification of eligible members and/or plans and validation of customer policies to confirm rebate and chargeback eligibility
Respond to, research and address customer discrepancies and/or disputes to determine eligibility based on contractual terms within specified timeframes. Accurately and concisely deliver customer-centric communication in response to disputes
Support strategic assessments of the benefits and impact of automation or implementation of digital solutions to business-critical processes. Collaborate with DTE to Improve system(s) capabilities to meet evolving business requirements and seek process efficiencies
Model N/Revitas Chargeback module SME including capability to establish complex calculations within systems, or alternative manual spreadsheets if not systematically possible. Partner with DTE to manage enhancement backlog, trouble shoot issues
Research, review, and interpret complex data to evaluate performance criteria on a unit-by-unit and customer-by-customer basis, identify trends and key insights. Experience validating chargebacks, monitoring program utilization and assisting with compliance and contract management
Determine Classes of Trade based on eligibility rules and assess the compliance of programs
Qualification
Required
Bachelor's degree in business or technological discipline required (e.g., Engineering, Computer Science, Accounting, Statistics, Economics, Finance)
8+ years US pharmaceutical industry experience with increasing responsibilities in contract operations, contract management, financial analysis, membership management, processing, and payments to FSS, Wholesalers, GPOs and IDNs
5+ years' experience with managed care contract admin technology (i.e. Model N, EDI, GPO's)
Experience with GPO rosters and internal discount programs
Working knowledge of the 340B program and government regulations
Proven ability to work in a fast-paced complex, customer-focused environment
Proven ability to build collaboration and drive problem-solving within and across teams
Proven ability to influence stakeholders through effective written and verbal communication
Excellent strategic thinker with analytical and solutions-driven mindset
Intellectual curiosity, active listener, and willingness to challenge the status quo and experiment when appropriate, focusing on continuous learning and improvement
Solid knowledge of Government Pricing calculations, Medicaid, Medicare and FSS
Strong business acumen, passion for innovation, ability to navigate ambiguity, and manages well through complexity. Excellent organizational skills and attention to detail
Effective communicator, someone who can inspire and energize people with ideas and ability to influence decision-makers through incisive analysis and persuasive communication
High level of proficiency in Microsoft applications, including Excel, PowerPoint and Word
Preferred
MBA, MPH or a Master's in a quantitative discipline
8+ years in biotech/pharmaceuticals in a quantitative role in Managed Markets / Commercial / Finance / Investment Banking, or 3+ years in biopharma consulting (management, strategic or economic consulting) post-MBA/PhD, with meaningful biotech/pharmaceuticals with direct reports and quantitative decision support experience
Project management experience and familiarity with project management techniques
US product launch experience, cell and gene therapy a plus
Contract strategy implementation experience
Value based contract implementation experience highly preferred
Experience in working with senior leadership to support financial forecasting and analytics, and/or commercial launch planning
Knowledge of AI/ML tools, query languages/tools (SQL, Alteryx), blockchain technology and data visualization tools
Benefits
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)
Company
Vertex
Vendor intelligence that combs through your supplier, manufacturer, logistics data to detect where you're leaving money on the table.
2-10 employees
H1B Sponsorship
Vertex has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (27)
2024 (18)
2023 (7)
2022 (13)
2021 (5)
2020 (7)
Funding
Current Stage
Early StageCompany data provided by crunchbase