Manager, Government Pricing & Medicaid

Manager, Government Pricing & Medicaid

Performs government price calculations, analysis and submission of all mandated products and pricing data for all federal and state government programs. Processes current/prior quarter Medicaid invoices and submits payment package with another team member. Responsible for resolution of data discrepancies and providing relevant supporting documentation to government agencies, as needed including CMS (Centers for Medicare and Medicaid Services), HRSA (Health Resources and Services Administration) and the VA (Veterans Administration).

Responsibilities

• Responsible for performing end-to-end calculations and initial analysis of government price calculations for AMP, BP, URA, Non-FAMP, FSS, FCP, IFF, ASP and PHS prices.
• Ensure timely and accurate calculation of government prices based on monthly, quarterly, and annual schedules, and report them to relevant government agencies.
• Perform re-calculation of statutory pricing requirements, as needed, and provide analysis on financial impact to 340B, Medicaid and/or VA.
• Process quarterly Medicaid invoices in Vistex to include retrieving e-invoices or scanning mail invoices, loading invoices in Vistex, identifying and resolving disputes with Medicaid state representatives, submitting invoices for payment, and creating payment packages with another team member.
• Maintain working knowledge of the Medicaid Drug Rebate Agreement, the Federal Supply Schedule agreement, 340B Pricing, and regulatory/legislative changes that impact pricing, contracts, and all Federal and State statutory calculations.
• Review and analyze customer pricing, class of trade and transactional data for correct classification and inclusion/exclusion in the government pricing calculations.
• Perform analysis on fluctuations in reported pricing and provide detailed explanations for significant increases or decreases.
• Collaborate with various departments to resolve all source system data issues identified in the data reconciliation and validation process prior to calculations being processed.
• Provide support to Sr Director, Government Pricing and GTN including updates/changes to department policies/procedures to allow for continuous business process improvement.
• Maintain appropriate written and electronic documentation consistent with approved policy and various state and federal requirements.

Qualifications

• Bachelor’s degree in business, Finance, or Accounting from an accredited college or university is required.
• Minimum of 3-5 years of experience in Government Pricing and Medicaid is required.
• Organized and very attentive to detail with a high degree of accuracy to ensure compliance with timelines, internal policies, laws and regulations.
• Proven analytical and problem-solving skills.
• Strong Excel and Word skills are required, Vistex and SAP ERP experience is strongly preferred.
• Effective written and oral communication skills.
• A self-starter with ability to work independently to manage multiple tasks, priorities and timelines.
• Ability to successfully interact with upper management and external government contacts.

Base salary range: $100,000 - $140,000 per year. This is the anticipated salary range for fully qualified candidates. The final salary offered will be dependent on several factors that include and are not limited to relevant previous experience, job responsibilities and duration of experience, the type and length of experience within the industry, education, etc.