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Rebate Operations Manager

Semma Therapeutics

Semma Therapeutics

Boston, MA, USA
Posted on Sunday, June 25, 2023

Job Description

The Rebate Operations Manager administers contractual obligations under the US Medicaid Drug Rebate Program (MDRP), as well as Canadian Rebate Programs, and the associated analytics and reporting obligations. As a member of the Rebate Operations team, the manager supports data validation activities, administration of rebate operations, provides accurate and compliant processing of payments of US and Canadian Government rebates to our customers, and ensures that payments adhere to all applicable requirements. This position will also be a key role in supporting of activities such as rebate/cash forecasting, government and customer reporting, program payment leakage identification, mitigation and dispute resolution, as well as process and system improvements and implementations.

This is a Remote eligible role.

Key Duties and Responsibilities:

  • Process claims to ensure accuracy and completeness of rebate payments; minimize revenue leakage and interest on late payments in a timely manner through collaboration with Accounts Payable and Treasury.
  • Negotiates effectively with external parties, including government agencies on rebate and contractual obligations and/or disputes.
  • Provides quarterly updates of rebate trends and variance analyses and maintenance of KPIs.
  • Set up and maintain programs/contracts within applicable systems and applications.
  • Validate contract updates for federal, state, and supplemental rebate programs. Testing of program set-ups and expected functionality with IT business partners.
  • Support processes and systems for identification of potential sources of rebate payment leakage. Assist in verification and dispute resolution through good faith inquiry to Covered Entities and State Agencies.
  • Works collaboratively with cross-functional business partners on forecast and accrual estimates, reporting, and dispute resolutions and analysis.
  • Assists with special projects. Works closely with Data Technology Engineering Teams (IT and/or external vendor) to build the infrastructure and tools to support rebate dashboards and analytical models. Optimize analytics and data for reporting and analysis of customer rebate trending and insights.
  • 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.

Education and Experience:

  • A Bachelor’s degree in Business, Finance, Accounting or Public Policy, or equivalent working experience.
  • 5 years of experience in Medicaid or Rebate Claim processing with a pharmaceutical company and/or state agency or as a Life Sciences Management Consultant, or equivalent combination of education and experience.
  • Experience with effective management of large datasets, managing peak cycle workloads and contract administration activities.
  • Intermediate knowledge of Model N or Revitas/Flex Medicaid or Flex Validata systems (or comparable contract and payment system) and data query tools.
  • Familiarity with relevant federal and state agencies, CMS Medicaid statutes and program operations, state specific issues and VA Health Care Act.

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

  • Collaborator in an environment of openness and trust through teamwork and self-accountability; offers support, training, and encouragement to others.
  • Applies experience, structured thinking, emerging knowledge, and trends to help solve problems logically.
  • Ability to prioritize and focus on activities that drive value.
  • Consistently meets or exceeds objectives and goals.
  • Track record of self-development and contributions to the function’s overall success.
  • Strong Excel, Word and PowerPoint skills are required.
  • A self-starter with ability to work independently.
  • Able to develop and communicate potential enhancements to operating processes and procedures, contributing to the growth opportunities within the function.

Pay Range $117,360 - $176,040 USD annually

The range provided is based on what we believe is a reasonable estimate for the base salary pay range for this job at the time of posting. This role is eligible for an annual bonus and annual equity awards. Some roles may also be eligible for overtime pay, in accordance with federal and state requirements. Actual base salary pay will be based on a number of factors, including skills, competencies, experience, and other job-related factors permitted by law.

At Vertex, our Total Rewards offerings also include 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. From medical, dental and vision benefits to 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) and so much more.



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