Sr. Manager, Government Program Compliance (Work-Flex - Stamford, CT)

Job Summary Manage government pricing and managed care internal audit programs. Ensure Pricing and Contract Administration (“PCA”) reviews and updates its SOPs, WPDs, and other relevant documentation on an annual basis (working with applicable internal teams). Ensure compliance with company policies and legal obligations. Primary Responsibilities

• Responsible for managing internally generated independent audits of processes and procedures related to government pricing calculations and procedures, government contract administration, government program obligations, customer master scrubs, and certain customer contract administration functions that relate to government price reporting (including audits of our chargeback processing and GPO/trade fee and rebate processing vendors)
• Oversee audit vendor in its three-year rolling audit schedule, ensuring a complete rolling audit plan, ensuring audits are begun and ended timely each year, and working with internal stakeholders to ensure timely and complete internal responses to such audits.
• Work with managed care rebate processing team to manage our third-party audit vendor; audit managed care customer compliance with managed care agreements.
• From any audit reports, create action plans to implement relevant internal or external audit recommendations and collaborate with government pricing team to ensure timely implementation of action items; monitor and track action plan implementation.
• Present audit findings, action plan (and results), and recommended future actions to Pricing Committee (or other Committees as requested), as well as the annual audit plan for government pricing and managed care audits.
• Work with relevant internal stakeholders to ensure all SOPs, reasonable assumptions, procedures documents, and other relevant documentation in Pricing and Contract Administration are reviewed annually and updated if needed; ensure legal review of documentation as appropriate.
• Ensure GP Library and Company SOP portal is updated timely with applicable updated PCA documentation; create and maintain PCA SOP/WPD/Documentation list.
• Internal point person to oversee responses to government agency audits of government pricing, government contracts, or government programs.
• Work with Compliance and/or Law Department(s) to schedule annual training and education for all relevant stakeholders on government pricing and government program compliance.
• Attend certain industry conferences (virtually or in-person) to maintain updated knowledge of government pricing and government program regulations and compliance issues.
• Review proposed government regulations for potential impacts to the Company; work with relevant internal teams to determine impact on the Company and any potential policy or procedure changes required.
• Manage annual SAM certification and updates, working with internal stakeholders to ensure review of relevant company certifications and timely annual re-registration.
• Other PCA projects as assigned.

Education and Experience Requirements

• Minimum 10 years’ experience with government price reporting, including 3 years’ experience with government price reporting audits (internal, external consultant or government), whether managing the audit or managing pharma company response to audits.
• BS or BA degree required; graduate degree a plus.

Necessary Knowledge, Skills, and Abilities

• Expertise/Knowledge – Must have the following:
• A solid understanding of all government programs (Medicaid, FSS, PHS, Medicare Part D, Medicare Part B, and Tricare), of related government pricing calculation or payment requirements, and of underlying statutes, guidance, and regulations.
• A general foundational understanding of
• institutional markets, including business processes, strategies, structure of relationships and the GPO industry and chargeback program.
• the intricacies of government program administration with respect to the 340B program and the Federal Supply Schedule, and corresponding contracts.
• brand and generic pharmaceutical markets, market access, trade, and supply chain
• Experience creating or updating government price reporting policies and procedure documents.
• Skills/Abilities –
• Excellent communication skills, strong interpersonal skills for collaborating with stakeholders and managing vendor projects
• Excellent writing and documentation skills
• Ability to manage projects, track results and deliverables, ensure project stays on time
• Highly organized with keen attention to detail

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