Government Pricing Compliance Senior Manager

Job Description

• 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.
• Supports 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, Legal and broader Commercial Business Partners on contract reviews, assessing contractual terms, Bona-Fide Service tests (BFSF), FMV, Class of Trade Assessment, and other Government Pricing analysis.
• Leads contract assessments of all BFSF tests, ensuring four-part tests is appropriately analyzed, interpreted and documented, the highest level of compliance.
• 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.
• 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).

• A Bachelor’s degree in Business, Finance, Accounting or Public Policy, and/or equivalent working experience. An MBA or other related graduate-level degree is a plus.
• 4-6 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 and passion for pricing policy research (qualitative and quantitative impact assessments).
• Strong analytical skills to interpret complex data and market trends for FMV assessments.
• Must show 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.
• Experience reviewing commercial contracts, for entities such as Specialty Pharmacies and Distributors, Wholesalers, PBMs, GPOs, or Copay vendors, etc.

• Collaborator in an environment of openness and trust through teamwork. Consistently meeting and exceeding objectives and goals for the team.
• Executes with a level of high personal accountability. Ability to prioritize and focus on activities that drive value and increase compliance and effectiveness.
• Attention to detail and a high degree of accuracy, necessary to ensure compliance with timelines, internal policies, laws and regulations.
• 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.

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 [email protected]