Sr. Manager, 340B Compliance

4 weeks ago

Boston, United States Vertex Full time

Job Description

The Sr. Manager, 340B Compliance & Analytics is a critical role, reporting to the Director, Rebate and Chargeback Operations as part of the Pricing, Analytics & Contract Management (PACM) team within the US Market Access organization. This is an exciting opportunity for a subject matter expert that applies an enterprise-level mindset and technical expertise at the intersection of data, process optimization, automation, and innovation.  

This role will interact with senior Commercial leadership and the successful individual must be extremely knowledgeable on 340B program, proven ability in utilizing technology to realize operational efficiencies, and have a high degree of attention to detail and accuracy to mitigate revenue leakage. Primary responsibilities include identifying and communicating trends and insights to key stakeholders, develop existing tools/new technologies for advanced data analytics capabilities as we expand into new disease areas, enhancing 340B disputes and resolution processes. This role is expected to operate with compliance and integrity and contribute to Vertex’s corporate goals. 

Key Responsibilities: 

  • Stay current with 340B program regulations and guidelines, trends, and public policy rulings at the Federal, State, and local level in collaboration with Government Pricing, Policy, and Legal teams. Support analysis on potential impact assessments and 340B program general education of internal stakeholders. 

  • Responsible for managing 340B Customer Master eligibility status and pricing within appropriate systems in partnership with Government Pricing team and other cross-functional partners and communicating eligibility and pricing to wholesaler through appropriate channels.  

  • Responsible for identifying potential duplicate discounts and working with Rebate and Chargeback Operations team to communicate dispute to appropriate entities, monitor resolutions, report impact, and communicate trends to cross-functional partners including Trade, Government Pricing & Transparency, Gross to Net teams, etc. 

  • Develop complex excel models for various analyses, provide formal presentations to Sr. Leadership, and participate in contract reviews as requested. 

  • Compliantly update organizations Covered Entity leakage dispute and audit processes, as necessary, including process development design and documentation, tracking, monitoring, and reporting. 

  • Drive, with Data & Technology Enablement (DTE) and Center of Excellence teams, enhancements of existing tools, utilization of available data and resources, and assessments of new technologies to improve reporting and analytics capabilities in a compliant manner as we expand into new disease areas.  

  • Participate in system implementation efforts, as necessary, which includes but not limited to, development and testing of functional requirements, documentation of formal testing, communicating issues and/or defects, and supplying insights in ongoing meetings. 

  • Lead and/or partner with various cross-functional stakeholders on projects, which includes evaluating operational feasibility and compliance, assessing, and communicating impact on processes and documentation, and participating in implementation efforts as needed. 

 

Minimum Qualifications: 

  • Bachelor’s degree in a quantitative or technological discipline required (e.g., Engineering, Computer Science, Accounting, Statistics, Economics, Finance) 

  • 5+ years US pharmaceutical industry experience with increasing responsibilities in 340B public policy, Government Pricing calculations, financial analysis, chargeback validation, processing, and payments to FSS, Wholesalers, GPOs and IDNs.  

  • 5+ years’ experience with managed care contract admin technology (i.e. Model N, EDI, Helix). 

  • Knowledge of AI/ML tools, query languages/tools (SQL, Alteryx) and data visualization tools. 

  • Proven ability to work in a fast-paced complex, customer-focused environment.  

  • Proven ability to build collaboration and drive problem-solving within and across teams. 

  • Proven ability to influence stakeholders through effective written and verbal communication.  

  • Excellent strategic thinker with analytical and solutions-driven mindset. 

  • Intellectual curiosity, active listener, and willingness to challenge the status quo and experiment when appropriate, focusing on continuous learning and improvement. 

  • Strong business acumen, passion for innovation, ability to navigate ambiguity, and manages well through complexity. Excellent organizational skills and attention to detail.  

  • Effective communicator, someone who can inspire and energize people with ideas and ability to influence decision-makers through incisive analysis and persuasive communication. 

  • High level of proficiency in Microsoft applications, including Excel, PowerPoint and Word. 

  

Preferred Qualifications: 

  • MBA, MPH or a Master’s in a quantitative discipline. 

  • 8+ years in biotech/pharmaceuticals in a quantitative role in Managed Markets / Commercial / Finance / Investment Banking, or 3+ years in biopharma consulting (management, strategic or economic consulting) post-MBA/PhD, with meaningful biotech/pharmaceuticals with direct reports and quantitative decision support experience. 

  • Project management experience and familiarity with project management techniques.  

  • US product launch experience, cell and gene therapy a plus. 

  • Experience in working with senior leadership to support financial forecasting and analytics, and/or commercial launch planning. 

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