Government Pricing, Manager

Job Description

Job Description:

Vertex Pharmaceuticals Inc. is seeking a Government Pricing Manager, reporting to the Associate Director of Government Pricing within the US Market Access department. This rapidly expanding function includes all aspects of Government Pricing (GP).

This is a new role in our growing team where the successful candidate will be relied upon for price reporting obligations for programs administered by Centers for Medicare and Medicaid Services (CMS) and the associated contractual obligations. As a member of the Government Pricing Team, you will oversee government pricing calculation activities, including transactional data analysis, calculation execution, documentation, and submission of pricing to the various agencies. This individual will also be a self-starter and ensure the accuracy and quality of calculations through the maintenance and development of accurate and up-to-date policies and procedures, as well as support the expansion of our systems for emerging calculations and contracting requirements. This position will provide critical insights to gross-to-net and rebate operations, and support expansion of processes as Vertex expands into new therapeutic areas.

Position Summary:

• Key contributor within the Government Pricing Team, with demonstrable knowledge and experience in government pricing calculations and reporting including Medicaid and Medicare programs.
• Manages reporting of monthly and quarterly pricing obligations to CMS, including source data reconciliation, calculation, documentation, and pricing submission. Collaborates with cross-functional teams to understand and resolve reconciliation and data issues timely.
• Maintains accuracy of calculations within applicable systems and applications. Participates in testing of calculation set-ups and functionality through collaboration with Data Technology Engineering Teams (DTE; internal IT and/or external vendor) and business partners.
• Works with cross-functional business partners on forecast and accrual estimates, modeling, and analysis.
• Develops actionable and tactical recommendations that enable Vertex to adapt processes and systems from evolving changes in U.S. government payer practices, policies, relevant legislation, regulations, trends and other dynamics.
• 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.
• Assists with special projects. Works closely with DTE to build the infrastructure and tools to support pricing calculations.
• Assists with system upgrades & process improvements across the various calculations and within the integrated Model N system. Provides guidance and oversight to the DTE team for related testing and validates system changes.
• Reconciles third party and internal transactional data to Revitas system, including sales, chargebacks, credits, rebates, fees, and other applicable discounts. Collaborates with Rebate Operations, Trade and Distribution, Trade Account Managers, Third Party Logistics providers, and Accounting for timely resolution of any data processing errors, reconciling items and/or adjustments. Coordinates resolution of data scrubs and/or validations. Assesses data adjustments to government pricing data. Maintains detailed support for all required data modifications.

Who you are:

• A Bachelor's degree in Business, Finance, Accounting or Public Policy, and/or equivalent working experience. MBA or other related graduate-level degree is a plus.
• 3-5 years of experience in pharmaceutical/biotechnology industry or state agency, with experience in Government Pricing, Accounting/Finance, or other related government payer/program administration experience.
• Experience with effective management of large datasets and data query tools.
• Must demonstrate a high level of proficiency with Microsoft Access, Excel, PowerPoint and Word.
• Ability to managing peak calculation cycle workloads and documentation activities.
• Systems knowledge of Model N or Revitas/Flex is a plus
• Strong knowledge/understanding of drug contracting, government and commercial customers, and the 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).

A successful candidate will demonstrate the following competencies critical to this role:

• Collaborator in an environment of openness and trust through teamwork.
• Executes with a level of high personal accountability to meet statutory reporting timelines.
• Ability to prioritize and focus on activities that drive value and increase operational effectiveness.
• Consistently meets or exceeds objectives and goals for the team.
• Strong verbal and written communication skills, time management, and organization.
• Track record of self-development. Contributions to the function's overall success and depth of knowledge.
• Applies experience, structured thinking, emerging knowledge, and trends to help solve problems logically.

Preferred Skills:

• Experience working with Revitas Model N Flex suite of applications.
• Government Pricing, Financial, Accounting, or Auditing experience.

Pay Range:

Disclosure Statement:

Flex Designation:

Flex Eligibility Status:

In this Remote-Eligible role, you can choose to be designated as:
1. Remote: work remotely five days per week and come into the office on occasion - you're always welcome on-site; or select
2. Hybrid: work remotely up to two days per week; or select
3. On-Site: work five days per week on-site with ad hoc flexibility.

Note: The Flex status for this position is subject to Vertex's Policy on Flex @ Vertex Program and may be changed at any time.

Company Information

Vertex is a global biotechnology company that invests in scientific innovation.

Vertex is committed to equal employment opportunity and non-discrimination for all employees and qualified applicants without regard to a person's race, color, sex, gender identity or expression, age, religion, national origin, ancestry, ethnicity, disability, veteran status, genetic information, sexual orientation, marital status, or any characteristic protected under applicable law. Vertex is an E-Verify Employer in the United States. Vertex will make reasonable accommodations for qualified individuals with known disabilities, in accordance with applicable law.

Any applicant requiring an accommodation in connection with the hiring process and/or to perform the essential functions of the position for which the applicant has applied should make a request to the recruiter or hiring manager, or contact Talent Acquisition at ApplicationAssistance@vrtx.com