Position Purpose: The Manager, Pricing & Government Reporting will lead the Government price reporting processes including monthly/quarterly calculations of pricing to Veteran Administration (VA), Public Health Services (PHS), and Centers for Medicare and Medicaid Services (CMS). Responsible for data accuracy & completeness, ensuring integrity of aggregated data across all sources, and reviewing and analyzing federal and state disclosures of Government Price types in order to meet federal reporting requirements. Additional responsibilities include: Federal Contract lifecycle management, supporting commercial operations core business processes; implementing strategies and recommendations for improving processes, efficiency and practices; help to identify and prioritize service improvement opportunities and advise operational impact and help plan for implementation; assist in the development, update and review of Standard Operating Procedures (SOPs) related to the disclosure of government prices to comply with federal and state legislative requirements.
Main Responsibilities & Accountabilities:- Manage price reporting for multiple federal government programs and implement methodologies for calculating and reporting pricing for CMS including: AMP/ASP reporting, Medicaid/340B pricing, Federal Supply Schedule and any other government agencies.
- Calculate, review and analyze Quarterly/Monthly government price types including understanding period over period variances and relation to other price types. Ensure compliance with all program requirements and data integrity for all supporting systems. Collaborate with the GP & Finance teams to ensure rebate accruals are sufficient and gross-to-net impacts are fully considered.
- Assist with configuration updates, including design & testing, of all government price types' filters/formulas in Model N, coordinating cross-functionally with IT & other stakeholders. Ensure expected results are appropriately calculated and aligned to documented Policies & Procedures. Lead Model N activities as GP/Pricing SME.
- Responsible for maintaining and updating all government pricing related internal control procedures and job aids on a regular basis to ensure reflect up-to-date processes, compliance and audit readiness, in coordination with the Sr. Manager, Government Reporting. This includes ensuring alignment to implemented Policies & Procedures.
- Complete fulfillment of all Federal and state specific pricing transparency requirements. Coordinate the activities of both internal and external resources to manage the required data collection and submit all reports needed for compliance.
- Assist with review and understanding the financial impacts of new/proposed government programs
- Responsible for cross-functional coordination with Contract Administration and Customer Support/HCS teams regarding contracts changes, rebates, & fees to determine appropriate classification of customers and transactions. This includes reviewing/approving the customer class of trade for direct/indirect accounts in accordance with Federal regulations
- Working with IT, translate complex reporting and compliance environment into efficient systems that meet needs of business and government requirements. Leverage understanding to contribute to the development and deployment of innovative approaches and capabilities that are critical to the functional and business strategy.
- Support governance and compliance support for Audit, Legal or Finance as requested
- Provide management oversight on the records supporting the disclosure of data to federal and state agencies. Ensures compliance to federal record retention requirements.
- Collaborate with SPC, MAA, and Finance on design and implementation of pricing strategy, tactics, policies and procedures as they relate to government programs.
Position Qualifications & Experience Requirements:Education:Requires a Bachelor's degree, preferably in Business, Life Sciences, or Healthcare Policy and 8+ years of biotech/pharmaceutical experience.
Experience:
Strong knowledge of the regulatory requirements for MDRP, Medicare/IRA, Veteran's Healthcare Act, and other Federal regulations mandating price and/or transparency disclosures.
Experience with implementation and utilization of pricing systems. Model N preferred.
Demonstrated ability to function independently, critical thinking, prioritization and coordination of job responsibilities
Competencies:
Total work systems
Business Acumen
Intellectual Horsepower
Process Management
Managing through systems
Integrity and Trust
Developing direct reports and others
Comfort around Higher Management