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Government Price Reporting Manager

Semma Therapeutics

Semma Therapeutics

Multiple locations
Posted on Tuesday, March 5, 2024

Job Description

Vertex Pharmaceuticals Inc. is seeking a Manager 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 Manager position is a new role in our growing team. A 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.

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 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)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.
  • 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.

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Pay Range:

$129,440 - $194,160

Disclosure Statement:

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 ApplicationAssistance@vrtx.com