Note: The job is a remote job and is open to candidates in USA. Vertex Pharmaceuticals is a global biotechnology company that invests in scientific innovation. The Rebate Operations Manager will oversee end-to-end commercial rebate contract administration, compliance, financial analysis, dispute resolution, reporting, and process optimization within the US Market Access organization. The role will collaborate cross-functionally to support rebate infrastructure, audits, regulatory requirements, and accurate customer payments.
Responsibilities
- Responsible for end-to-end contract administration operations, which includes contract set-up in Model N/Revitas, rebate eligibility, duplicate discount validation, dispute and customer payment administration of traditional and value-based Commercial 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
Skills
- 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
Benefits
- Annual bonus
- Annual equity awards
- Medical benefits
- Dental benefits
- Vision benefits
- Generous paid time off
- A week-long company shutdown in the Summer
- A week-long company shutdown in the Winter
- Educational assistance programs including student loan repayment
- Generous commuting subsidy
- Matching charitable donations
- 401(k)
- Remote work five days per week in the Remote designation
- Hybrid work remotely up to two days per week in the Hybrid designation
- On-site work five days per week with ad hoc flexibility in the On-Site designation
Company Overview