Manager, Gross to Net and Government Reporting

Responsible for the oversight and supervision of the third-party vendors responsible for processing commercial and government rebate submissions, data analysis, pricing calculation and submission of State/Federal Price Reporting (Medicaid Drug Rebate Program, Federal Supply Schedule, Tri-Care, 340B, Medicare Part D, etc.). Also, responsible for reviewing monthly and quarterly book close and reporting for gross to net and transparency reporting and submissions and confirming that all government rebate requests are processed and paid in a timely manner.

 

Primary Responsibilities:

·         Managing gross to net model calculations vendor as well as government price reporting vendor. Ensures that all government price reporting processes and procedures are well-documented.

·         Accountable for accurate calculations and timely submissions of all government price reporting obligations, including but not limited to: AMP, BP, FCP and 340B/PHS.

·         Analysis of fee and rebate payments for GPO, Distribution, Specialty Pharmacy, and Managed Care contracts and ensure they are properly applied to, and in compliance with, all Government price types.

·         Oversee the administration of the Federal Supply Schedule. Ensure all new products to the FSS contract and calculating provisional, temporary and permanent Federal Ceiling Prices ("FCPs"). Oversee the preparation, completion and submission of the annual Public Law update in accordance with the guidance provided by the VA. Submit any required contract modifications forms to VA based on business needs. Ensure timely and accurate administration of all pharmaceutical government rebate contract agreements between DSI and government agencies.

·         Ensure timely and accurate administration of all pharmaceutical rebate contract agreements between DSI and external customers - including but not limited to Commercial, Medicaid, Coverage Gap, and Tricare. Manage the validation of quarterly payment calculations to ensure accuracy and compliance of payments and financial reporting.

·         Accountable for accurate and timely submissions of all transparency reporting, including but not limited to Sunshine Law.

·         Other duties as assigned.

Education/Experience/Skills:

Bachelor's degree in finance, health care, business administration or related; Master's degree preferred. Requires minimum of 5 years of progressively responsible experience in GTN and/or GP.

Must possess:

·         Working knowledge of reimbursement, clinical coding/terminology, managed care and healthcare policy.

·         Good understanding of regulatory, legal, compliance requirements for success.

·         Strong analytical abilities and project planning skills.

·         Ability to effectively communicate in verbal, written, and presentation form.

·         Strong analytical, problem-solving and decision-making skills.