Senior Director - Government Pricing

Job Description

General Summary:

The Senior Director, Government Pricing will lead the tactical, compliance, and strategic oversight of the Government Pricing and Transparency team. The team is comprised of complementary functions: Government Pricing Operations, Compliance, and State Price Transparency. This position will collaborate closely with the Managed Markets Specialty Pharmacy and Payer Field teams, Accounting, Legal, Finance, Global Information Systems, Government Affairs and Public Policy, OBIE, Treasury, Regulatory, Quality, and Pharmaceutical Operations. This role will demonstrate a level of detail, strategic understanding of Vertex business priorities, and executive presence.

Key Duties and Responsibilities:

• Serve as subject matter expert on Government Pricing calculations, methodologies, reporting obligations and Bonafide Service Assessments.
• Oversees and approves all Government Pricing (AMP, BP, ASP, NonFAMP and 340B) calculations, documentation, and reasonable assumptions, ensuring accuracy and compliance to regulations.
• Leads analytics and scenario planning efforts that proactively evaluates changes to Government (Medicaid, FSS, Medicare and 340B) programs considerations for in-line and launch products
• Supportcontract development efforts and collaborate with business partners with contract negotiations; ensures operational viability of rebate and payment processes contemplated by contract terms.
• Oversee state price transparency reporting
• Tracks state regulations and forecast assumptions; measures financial impacts to GTN
• Partners with GIS to ensure timely and compliant upgrades to Revitas modules.
• Sponsors or leads complex, cross-functional initiatives
• Leads, mentors, and develops team members to strengthen team expertise and performance
• Lead and oversees external audits and SOX compliance activities
• Lead and support implementation of regulatory changes
• Partner with legal and compliance to ensure operational alignment with current regulatory requirements.
• Oversee Bona Fide Service Fee assessments.

Knowledge and Skills:

• Experience with forecasting, modeling and estimation of financial impacts to GTN
• Demonstrated knowledge of US payer landscape and public policy developments
• Strong written, communication and presentation skills
• Experience leading people/teams with excellent cross-functional leadership and collaboration skills
• Experience in leading contracting strategy, contract management and contract operations a plus
• Advanced understanding of commercial and government payers
• Familiarity with distributors, 3PLs, limited distribution networks and specialty products
• Dedication to cross-functional partnership and building/maintaining positive relationships across teams
• Familiarity with distribution practices in assigned geographic region(s)
• An advanced understanding of FSS and CMS statutory programs and price calculations (NFAMP, IFF, AMP, BP, URA), State Price Reporting requirements, the 340B Program, Coverage Gap Discount Program and Tricare.
• Familiarity with chargebacks processes and membership management
• Experience with Revitas or Model N systems
• Knowledge of GXP

Education and Experience:

• Bachelor's degree required
• 12+ years of professional experience in pharma/biotech industry/ relevant consulting environment, including 5 years of supervisory/management experience, or the equivalent combination of education and experience

At Vertex, we embrace continuous learning and encourage employees to stay informed on advances in AI, technology, automation, and industry trends. We seek talent who bring an external perspective, demonstrate curiosity and sound judgment, and thoughtfully adopt new capabilities that improve decision-making, drive innovation, increase efficiency, and help deliver better outcomes for patients.

Pay Range:

$232,000 - $348,000

Disclosure Statement:

Flex Designation:

Remote-Eligible

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 [email protected]