Manager, Government Price Reporting & Analysis

Waltham, Massachusetts 02451 | Direct Hire

Post Date: 03/13/2018 Job ID: 3996 Industry: Finance

Position Overview:

The Manager, Government Price Reporting & Analysis (GPR&A) will oversee the day-to-day operations of the Medicaid team within the Finance department.  This role will report directly to the Director, GPR&A.  Principle responsibilities include, but are not limited to, Medicaid claim adjudication oversight and ownership, close interaction with Commercial Operations, FP&A, Accounting and IT, people management and system development.

Essential Functions:

  • Oversight of Medicaid Drug Rebate Program (MDRP) team and deliverables
  • Medicaid claim level detail (CLD) analysis and validation
  • Oversight of 3rd party data validation tools to identify duplication and otherwise erroneous claims
  • Review and approval of Medicaid payments
  • GPR&A lead for Medicaid accrual process and presentations to management
  • Supplemental Medicaid agreement review and implementation
  • Support setup of Medicaid contracts, membership and supplemental Medicaid agreements within the Model N (fka Revitas) Medicaid module
  • Interpretation & implementation of CMS guidance, as applicable
  • Review, maintain and improve existing Standard Operating Procedures (SOPs) and Work Instructions (WIs)
  • Lead special projects and analyses as required
  • Attend conferences and industry meetings as necessary annually

Education and Experience:

  • Bachelor’s degree required (Master’s degree a plus); equivalent work experience may be considered
  • 4+ years of pharmaceutical manufacturer Medicaid experience required
  • 2+ years of RMS experience (e.g. Model N, Revitas or similar platform)
  • Proficiency in MS Excel, PowerPoint, Visio and Word
  • Strong organizational, analytical and communication skills
  • Understanding of the current healthcare landscape
  • Understanding of corporate finance is a plus
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