Senior Manager, Inflation Reduction Act Program Analysis & Compliance

About The Department

The Finance & Operations department brings insights and intelligence to inform decision making & drives digitalization and business solutions to attain NNI goals. Finance & Operations works closely across the organization to guide enterprise-wide resource allocations, investment choices, drive core operations and develop insights to drive growth and operational excellence across the value chain while innovating for future capabilities. Our focus on innovation ensures we're constantly building future capabilities. We're responsible for regulating accounting, upholding workplace safety, managing our supply chain and sampling, supporting technological and data innovation, maintaining our facilities and assuring the integrity and completeness of all business transactions. At Novo Nordisk, you will have the opportunity to build a career in a global business environment. We encourage our employees to make the most of their talent, and we reward hard work and dedication with opportunities for continuous learning and personal development. Are you ready to maximize your potential with us?

The Position

Assist Director of Institutional Contracts in managing the development and implementation of 340B as well as Inflation Reduction Act ("IRA") processes and compliance activities for the Medicare Drug Negotiation Program. Ensures accurate and timely input and implementation of 340B requirements as well as Maximum Fair Price ("MFP") effectuation requirements consistent with regulatory requirements, NNI policies and procedures and Sarbanes-Oxley regulations. Co-develop processes to validate 340B Program processes as well as MFP refund processes, oversee general management, and modifications in the event of regulatory changes. Supports analytics, good faith inquiries, complaints, and post payment audits. Supports master data management requirements for the IRA, as required. Supports special projects for all U.S. government programs to assist with compliance and implementation of new and existing regulations.

Relationships

Reports to the Director of Federal and Institutional Contracts. Also works closely and supports MDRP, Chargebacks and Master Data Management. Also maintains relationships with the Finance, Pricing & Contracts, IT, Legal, Market Access and Field Sales. External relationships may include wholesalers, 340B entities, dispensing entities, vendors and other customers. Maintains a positive working relationship as an NNI representative to all stakeholders.

Essential Functions

• Supports resolution of government contract issues and compliance with 340B regulations and review of MFP refund payments within the 14-day payment window to confirm accuracy of refund calculation and adherence with NNI policies and procedures
• Coordinates maintenance of membership lists with Membership Team and supports onboarding new customers into Model N
• Oversees and manages issuance of 340B refunds to covered entities and MFP refunds to dispensing entities
• Assists with developing policies and procedures for 340B and MFP refunds
• Independently and proactively manages outsourced activities related to administration of 340B and MFP tasks
• Manage inquiries from 340B entities as well as responses to Good Faith Inquires (“GFI”) from dispensing entities
• Provide support for SOX inquiries and ensure adherence to SOX controls. Performs post audit reviews and analysis of 340B PHS chargebacks and MFP rebates
• Ensure timely receipt of claim-level data, transmission of payment elements, and submission of required information such as audit, complaint, and dispute data
• Proactively notify the MTF Data Module (“MTF DM”) Contractor of any system changes that may impact connectivity
• Update CMS with any changes to the Manufacturer MTF Enrollment Information within 30 calendar days of such changes
• Access claim-level data elements through the MTF DM and maintain functionality to receive and process this data
• Monitor for inaccuracies in previously transmitted claim-level payment elements
• Regularly update, correct, maintain, and re-certify the completeness and accuracy of Manufacturer MTF Enrollment Information within the MTF DM
• Utilize the MTF PM in alignment with the Manufacturer’s MFP Effectuation Plan and update the Plan as required by applicable guidance and regulations
• Provide accurate banking account information to the MTF Data Module Contractor in accordance with applicable guidance and regulations to facilitate MFP refund payments through the MTF PM
• Provide CMS with a minimum of 90 calendar days’ advance notice if the Manufacturer elects to cease utilizing the MTF PM
• Review and verify credits and debits using Ledger System data provided through the MTF DM to ensure accuracy
• Ensure that any outstanding credits are not treated as unclaimed funds and that related claims must be resolved directly with dispensing entities outside the formal dispute or complaint process
• Responsible for compiling, analyzing, creating and presenting 340B chargeback and MFP rebate reports and supports ad- hoc requests
• Supports changes and updates to Government Contracts & Operations department 340B and MFP administration work instructions and procedures when external changes in process occurs
• Provides 340B and MFP subject matter expertise in the form of advice and recommendations to internal stakeholders
• Supports the analysis and implementation of pending and new regulatory requirements for U.S. government programs
• Supports the analysis and implementation of 340B and MFP-related business initiatives
  
  

Qualifications

• A Bachelor’s degree required; relevant experience may be substituted for degree when appropriate
• A minimum of seven (7) years of progressively responsible, relevant experience with any or all the following: financial reporting, rebate adjudication, government programs and the IRA
• Pharmaceutical experience preferred
• Working knowledge of U.S. Government program related financial impacts and requirements preferred
• Working financial reporting knowledge of the 340B/PHS Program, entity types, CE relationships, 340B ecosystem and related stakeholders and other program requirements preferred
• Advanced proficiency in Microsoft Excel skills required, Microsoft Access and SQL Management Studio skills preferred but not required
• Experience with Master Data Management and Model N Revenue Management Suite preferred
• Excellent verbal and written communication skills
• Experience co-leading a project in the development and implementation of processes and programs
• Experience with recognizing trends, establishing a way forward, and focusing on the big picture as well as key details
• Demonstrated ability to be a self-motivator who consistently seeks to improve accuracy and efficiency of analytical work and business
• Attention to detail and ability to multi-task required
• Effective personal time management and organization skills
  
  

We commit to an inclusive recruitment process and equality of opportunity for all our job applicants.

We’re not your typical healthcare company. In a modern world of quick fixes, we focus on solutions to defeat serious chronic diseases and promote long-term health. Our unordinary mindset is at the heart of everything we do. We seek out new ideas and put people first as we push the boundaries of science, make healthcare more accessible, and treat, prevent, and even cure diseases that affect millions of lives. Because it takes an unordinary approach to drive real, lasting change in health.

Novo Nordisk is an equal opportunity employer. Qualified applicants will receive consideration for employment without regard to race, ethnicity, color, religion, sex, gender identity, sexual orientation, national origin, disability, protected veteran status or any other characteristic protected by local, state or federal laws, rules or regulations.

If you are interested in applying to Novo Nordisk and need special assistance or an accommodation to apply, please call us at 1-855-411-5290. This contact is for accommodation requests only and cannot be used to inquire about the status of applications.