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Associate Director, Government Pricing

Semma Therapeutics

Semma Therapeutics

Boston, MA, USA
Posted on Friday, March 1, 2024

Job Description

Vertex Pharmaceuticals Inc. is seeking an Associate Director of Government Pricing, reporting to the Director of Government Pricing within the US Market Access department. This rapidly expanding function includes Government Pricing (GP) and State Transparency Reporting.

The Associate Director position is a new and critical role in our growing team. A successful candidate will be relied upon as the subject matter expert for price reporting and contractual obligations for programs administered by Centers for Medicare and Medicaid Services (CMS), Public Health Services (PHS), and Veteran Administration (VA). This is an exciting opportunity for a subject matter expert to use his/her technical expertise in government pricing, enterprise-level thinking and leadership to provide direction at the intersection of policy, government pricing reporting, G2N forecasting, contracting strategy, and compliance. The ideal candidate is passionate about patient access, focused on driving for results, and intellectually curious.

As a member of the Government Pricing Team, you will review contracting proposals, as well as interpret new and evolving U.S. government payer policies, legislation, regulation and other external landscape dynamics to provide meaningful and actionable insights for Market Access. This role is responsible for delivery of technical and business expertise, guiding strategic forecast impact analysis and associated analytics, to proactively address current and future scenario planning, solving for “what if” type questions from stakeholders, and determining the impact of regulatory and contracting strategy changes. This position will collaborate in the shaping and development of Government Pricing Reporting policies and methodologies resulting from changes in the business and/or regulatory environment.

This role will also provide oversight to Government Price Reporting Compliance Programs, which include ensuring adherence to compliance requirements and appropriate conduct and/or assessment of risk mitigation activities. Activities may include continue contract compliance tracking, spearheading response and management of internal and external audits/reviews, and Sox compliance supervision.

This is a hybrid/on-site role based in Boston, MA (3 days onsite, 2 days remote on a weekly basis).

Key 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.
  • Works with cross-functional business partners on forecast and accrual estimates, pricing and G2N modeling, and analysis for new and evolving pricing legislation. Provides management findings and impact analysis for current and pipeline product considerations.
  • Develops 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 and Legal on contract reviews, assessing contractual terms, performing Bona Fide Service Fee tests, Class of Trade Assessment, and other Government Pricing analysis.
  • Create analytics, graphs, and slides that show policy impacts to government pricing data and answers business questions by using the government pricing data to present to Executive Leadership
  • 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.
  • Provide excellent insights to GtN Forecasting Accuracy and Business Decisions
  • 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).

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.
  • 10 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 effective management of large datasets and data query tools. Skilled at financial modeling and pricing policy research (qualitative and quantitative).
  • Must demonstrate a high level of proficiency with Microsoft Access, Excel, PowerPoint and Word.
  • Ability to multitask and prioritize workloads and activities.
  • Systems knowledge of Model N or Revitas/Flex is a plus

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:

  • Government Pricing, Financial, Accounting, or Auditing experience.

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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.