Senior Manager, Government Pricing
Other Locations:US- NJ- Summit East
Celgene is a global biopharmaceutical company leading the way in medical innovation to help patients live longer, better lives. Our purpose as a company is to discover and develop therapies that will change the course of human health. We value our passion for patients, quest for innovation, spirit of independence and love of challenge. With a presence in more than 70 countries, and growing - we look for talented people to grow our business, advance our science and contribute to our unique culture.
This position's primary role will focus on maintaining compliance with regulatory requirements for the Medicaid, Medicare Part B and other Federal pricing programs.
Key responsibilities will center on data analysis, pricing calculation and submission of State/Federal Price Reporting for the following:
- Monthly Average Manufacturer Price (mAMP)
- Quarterly Average Manufacturer Price (qAMP)
- Best Price (BP)
- Medicaid Unit Rebate Amount (URA)
- Medicare B: Average Sales Price (ASP)
- Quarter and Annual State Price Reporting
Candidate will be heavily involved in support and maintenance of Model N's GP and Medicaid modules including:
- Ongoing maintenance of Price Types that implement calculation methodologies and drive the “includes” and “excludes” in mAMP, BP and ASP calculations
- Setup and maintenance of Bundles and Discount Reallocations
- Liaise with Model N support to diagnose and repair system issues
- Perform user testing for patches, RUPs and upgrades.
Support calculation and submission of State/Federal Price Reporting for the following:
- 340B Program (Public Health Service - PHS)
- Veteran's Healthcare Act Section 602: Federal Supply Schedule (FSS)
- Quarterly and Annual Non-Federal Average Manufacturer Price (Non-FAMP)
- Federal Ceiling Price (FCP)
Candidate must be up to date with changes in HealthCare Reform laws and its impact on the various Government Price type calculations.
Candidate will be responsible for URA related tasks including: forecasting for Finance and Gross To Net, analyzing and explaining variations for changes due to commercial contracts and research of ad hoc historical URA items.
Maintain proactive communication and effective cross-functional relationships with Market Access Accounts Managers, Finance, Contract Administration, Information Technology, and Legal Departments, where appropriate, to identify transactions for all Government price types.
Ensure adherence to Celgene guidelines, policies and legal requirements in conjunction Federal and State pricing requirements.
Timely communication with the Director, U.S. Government Pricing Compliance on issues that may potentially impact any pricing calculation.
Responsibilities will include, but are not limited to, the following:
- Perform monthly data reconciliation prior to monthly pricing calculation to ensure complete set of data.
- Prepare monthly and quarterly documentation on Government Pricing Calculations and ensure proper sign-off for the calculations.
- Responsible for timely upload of new product and baseline pricing data into Model N to ensure accurate rate and pricing calculation.
- 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.
- Develop and/or maintain relevant working procedure documents on Government pricing processes and procedures, appropriate manuals, metrics analysis and measurement for process continuation and improvement.
- Assist with analysis of impact of new or changed contracting strategies on Government Pricing calculations.
- Assist in analyzing dispute and price change claims for resolution with State Medicaid Agencies; Interface with various state and Federal Government agencies.
- Ensure compliance to Internal Policies for proper controls and SOX Compliance. In addition, may develop Business Process Procedures and recommend improvements/changes to company policies and procedures.
- Understanding of wholesaler sales and membership. Working knowledge of the Third-party data sources for DEA#, HIN#, and PHS and FSS websites is preferred as well as uploading CPI-U rates etc into the Model N application.
- Bachelor's degree in Accounting, Finance, or Business Administration is preferred.
- Minimum of 5-7 years of experience in with knowledge of the inner workings of the Pharmaceutical Industry or relevant experience in Sales Operations, Commercial Analytics, Accounting or Finance is desirable.
- Government Pricing System experience required; Model N is preferred.
- Knowledge of Government Pricing, i.e. AMP and BP calculations and their relationship to Unit Rebate Amounts (URA) is required.
- Knowledge of Access, Excel, Word and PowerPoint.
- Strong analytical, problem-solving and decision-making skills.
- Possess a high level of energy, initiative, and ability to multi-task.
- Demonstrate integrity, flexibility, and a strong work ethic.
- Excellent communication skills (both oral and written), with the ability to communicate across multiple functions and levels.
- Ability to assess and communicate potential enhancements to operating processes.
- Familiarity and working knowledge of the government pricing regulations and ability to stay current with new and changing regulations and rebate programs.
- Ability to work under tight timelines.
- Results-oriented with a willingness to take on responsibility and manage multiple and varied projects.
- Must be a team player with the ability to work independently in a fast-paced environment.