Remote Pharmacy Operations Manager Jobs in Boston, MA

Job Description

The Manager of Commercial Rebate Operations has a critical role, reporting into the Associate Director, Rebate Operations 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. The ideal candidate is passionate about patients, focused on driving for results, and is willing to be involved in hands-on execution while building new functional capabilities.

The successful individual must be adept at cross-functional collaboration, while also having a high degree of attention to detail and accuracy to mitigate revenue leakage. This role is expected to evolve and anticipate the needs and capabilities of customers, adapting to our growing portfolio, operating with compliance and integrity and contributing to Vertex's corporate goals.

This role has the option for remote or hybrid/on-site based in Boston, MA (3 days onsite, 2 days remote weekly).

Key Responsibilities:

• Responsible for end-to-end contract administration operations, which includes contract set-up in Model N/Revitas, rebate eligibility, discount validation, volume reconciliation, dispute and customer payment administration of Traditional/Distributor/Specialty Pharmacy Service Fees and Commercial GPO/payer rebates.
• Establish and maintain policies, procedures, and standards of SOPs to ensure consistency within the payment packages.
• Support the commercial contracting strategy design, contract development, negotiation, and execution processes.
• Assist with special projects. Work closely with Data Technology Engineering (DTE) teams to build the infrastructure and tools to support rebate dashboards and analytical models. Optimize analytics and data for reporting and analysis of customer rebate trending and insights. Alternatively, proven capability to establish manual spreadsheets, to ensure accurate financial analysis, validation and payment and accurate translation into Government Price Reporting systems.
• Manage contract compliance, including timely verification of eligible plans and validation of customer policies to confirm rebate eligibility. This includes interpretation of medical policies, formularies, prior authorizations, benefit plans, reimbursements and pathways for Vertex products and competitors, where applicable.
• Research, review, and interpret complex data to evaluate performance criteria on a unit-by-unit and customer-by-customer basis. Perform complex financial analytics to further execute and validate rebate calculations to ensure accuracy.
• Respond to, research and address customer disputes within contractual timeframes to ensure obligations are met. Provide timely issue resolution that impacts multiple customer segments. Accurately and concisely deliver customer-centric communication in response to disputes and ensure compliance with the eligibility terms.
• Ensure timely ongoing maintenance of contract administration documentation to maintain detailed information for audit purposes.
• Stay current with all promulgated and proposed federal regulations that impact rebate and/or chargeback adjudications.
• Provide monthly and quarterly management reporting of contractual payment activities, dashboards and trends, support forecasting analyses and ad-hoc requests.
• Work collaboratively with stakeholders including but not limited to: Government Pricing & Programs, Contract Operations, GTN Forecasting, USMA Data & Analytics COE, Data & Technology Enablement (DTE), Public Affairs, Commercial Legal, Payer Accounts, Trade & Distribution FP&A, Revenue Accounting, Accounts Payable, Internal Audit etc. to ensure transparency and collaboration across key processes and decisions. Support for these activities will vary and may include ownership of parts of cross-functional processes.
• Supports all Sarbanes-Oxley (SOX) controls are met and have appropriate documentation. Participate in and support SOX-related, internal, and external audits.
  

Minimum Qualifications:

• Bachelor's degree in a quantitative or technological discipline required (e.g., Engineering, Computer Science, Accounting, Business, Statistics, Economics, Finance)
• 4-6 years US pharmaceutical industry-adjacent experience with increasing responsibilities in contract operations, contract management, financial analysis, rebate processing, and payments to commercial payers, GPOs, IDNs, Medicaid or U.S. Government.
• 2+ years' hands-on experience with managed care, Medicaid, or U.S. Government contract administration technology (i.e. Model N, Validata, EDI, Helix).
• 2+ years' experience in reviewing and interpreting Managed Care, Medicaid, or U.S. Government Master Agreements and Rebate Agreements.
• Proven ability to work in a complex, customer-focused environment with tight deadlines.
• Proven ability to build collaboration and drive problem-solving within and across teams.
• Proven ability to influence stakeholders through effective written and verbal communication.
• Proven ability to prioritize and focus on activities that drive value.
• Excellent strategic thinker with analytical and solutions-driven mindset.
• Excellent organizational skills and attention to detail.
• Intellectual curiosity, active listener, 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 manage complexity.
• High level of proficiency in Microsoft applications, including Excel, PowerPoint and Word.
  

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.

#LI-Remote

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