Director, USMA Payer Contract Operations

Job Description

General Summary:

Reporting to the Senior Director, Contract Operations & Deal Assessment, this role is responsible for leading the end-to-end contracting lifecycle, overseeing drafting, negotiation, execution, and compliance to drive revenue and mitigate risk across all franchises. This position will lead the Contract Operations team, develop standardized templates, manage playbooks, and optimize processes in support of the cross functional operations teams, Market Access Strategy, Account Leadership, and Legal. The ideal candidate will be familiar with and highly conversant in various segments of market access, discuss and incorporate contracting strategies and tactics, and understand the various types of managed care and trade contracting. This is a highly visible role that will be expected to build collaborative relationships with internal US Market Access and Field Account stakeholders.

Key Duties and Responsibilities:

• Direct and oversee the contract management system (iCertis) to track status, deadlines, and compliance. 
• Supervise, mentor, and lead a team of contracting professionals.
• Apply deep understanding of US Market Access environment, including payer landscape, role of PBMs (and PBM-GPOs), Hospital GPOs and IDNs, medical coverage policies, and reimbursement to the contracting, review, and negotiation process to provide strategic contracting support across multiple business segments
• Knowledge of traditional and innovative contracting approaches. 
• Translate pricing strategy into prospective payer contracting concepts and archetypes; coach, train, and guide team to apply best-practices in their daily work. 
• Foster relationships, building alignment, negotiate and collaborate with home office and field teams to develop key assumptions, build tools, deliver financial models and impactful business insights to enable optimal decision-making. 
• Establish and maintain policies and applicable documentation (e.g., Contract Summary Report) in accordance with established departmental guidelines to support Sox compliance. 
• Manage multiple projects concurrently and maintain organizational awareness to various projects and work streams. 
• Ensure successful contract data integration for new products and/or acquisitions. 
• Develop processes, metrics, and contracting tools to stay current with changing marketplace.
• Manage team participation in various cross functional projects and process improvement initiatives, ensuring effective communication and issue resolution internally.
• Oversee team relationships and collaboration with rebate operations team on payment terms, disputes, and audits
• Collaborate with Market Access field team and Market Access strategy team on priorities and timelines.
• Lead meetings with Account Directors related to current and upcoming account activities.

Knowledge and Skills:

• Ability to manage and prioritize multiple tasks and projects simultaneously, work independently as well as with a team, possess strong oral, written and interpersonal communication skills with a focus on customer service.
• Work in a demanding work environment, flexibility to adhere to unexpected deadlines, willingness to learn new skills, systems and processes.
• A successful candidate has a patient focused mindset, organized, driven, high attention to detail, accountable, and can achieve high quality results with compliance and integrity.
• Understanding of the US Payer Channel and Buy and Bill Reimbursement Landscape.
• Experience securing contract access for Specialty and/or rare disease medicines.
• Experience launching new products and indications.
• High level of proficiency in MS Office software including: Word, Excel, Outlook, Visio, and PowerPoint.

Education and Experience:

• Bachelor’s degree in a quantitative discipline required (e.g., Engineering, Statistics, Economics, Finance).
• 10 years of relevant experience; of which, at least 7 years of demonstrated experience with Market Access Contracting activities in the biopharmaceutical industry, including but not limited to specialty pharmacy, provider and managed care payors is required (health plans, pharmacy benefit managers, etc.).
• Experience with Full Line Retail and/or Rare Disease therapeutic areas.

Pay Range:

Disclosure Statement:

Flex Designation:

Flex Eligibility Status:

In this Hybrid-Eligible role, you can choose to be designated as: 
1.    Hybrid: work remotely up to two days per week; or select
2.    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-Hybrid
 

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]