Known for its scientific and operational excellence, Regeneron is a leading science-based biopharmaceutical company that discovers, invents, develops, manufactures, and commercializes medicines for the treatment of serious medical conditions. Regeneron commercializes medicines for eye diseases, high LDL-cholesterol, atopic dermatitis and a rare inflammatory condition and has product candidates in development in other areas of high unmet medical need, including rheumatoid arthritis, asthma, pain, cancer and infectious diseases.
The Manager, Government Pricing (GP) and Contract Operations position is a key member of Regeneron’s government pricing team, which includes supporting the accurate calculation and timely submission of all required government price reporting, in addition to all operational activities related to contracting, claims, and membership for all customer segments including Health Plans PBMs, GPOs, and Wholesalers.
Included in this role is responsibility for assuring compliance with all pricing and reporting requirements legislated by the Centers for Medicare & Medicaid Services (CMS), the Department of Veterans Affairs (VA) and any state legislation required price reporting. This includes a full understanding of all current legislation and staying abreast of pending legislation. Government Pricing Calculations include: Medicaid, Medicare Part B, Public Health Service (PHS)/340B, and Federal Supply Schedule (FSS), which includes: TriCare and Industrial Funding Fee (IFF). Additionally, the Manager, will review all rebate payments for completeness and accuracy managing revenue leakage. The manager will work collaboratively with Contracting Strategy and Account Directors supporting the overall strategy, contracting and/or payment activities. They will be responsible to ensure contract terms are aligned to intent and overall Regeneron requirements.
- Ability to calculate, validate and report accurate monthly, quarterly, and annual government pricing.
- Complete understanding of calculation reasonable assumptions and methodologies and ability to research and communicate cause of variances of results when comparing current period to prior periods.
- Perform all necessary processes needed to ensure compliant submissions including, but not limited to general leger reconciliations, class of trade (COT) review, and 340B eligibility review.
- Manager will review calculations with Senior Management and obtain approval signoff (and executes any other required standard operating procedures (SOPs)) before communicating prices to the appropriate government agencies or internally.
- Responsible for maintaining and updating SOP’s and reasonable assumptions, on a quarterly basis, as related to Government Programs/Pricing.
- Monitor policies, procedures and processes supporting Government Pricing submissions and related areas to ensure ongoing compliance with external and internal requirements and guidance.
- Understand and estimate impact of pricing and policy changes regarding government pricing.
- Perform pricing research and analysis on special projects as assigned.
- Ability to review and understand commercial contract language as pertaining to Best Price (BP), Average Sales Price (ASP) and FSS Tracking Customers.
- Investigate Government pricing trends and cross channel impact. Also provide Government price inputs to the gross to net team.
- Monitor for Tracking customer violations, Bona Fide Service Fee treatments & Customer COT assignment.
- Evaluate contracts for Fair Market Value.
- Responsible for timely and accurate execution of discounts for contracted customers, which includes ensuring compliance against applicable Commercial contracts, validating and processing data from multiple sources including third parties, disputing and resolving data discrepancies, calculating contract performance and payment processing.
- Effectively communicate to senior management and stakeholders (Account Directors & Contract Strategy) any contract and/or payment development progress, issues and risks.
- Evaluate new and modified payer, government, and commercial contracting proposals, perform risk assessments, adhere to operational processes and SOPs, and recommend business improvement initiatives where appropriate.
- Participate on cross-functional teams as a subject matter expert representing the Government Pricing and Contract Operations as required to evaluate and implement business strategies and initiatives.
- Serve as a liaison with Commercial Leadership, Customer Service, Brand and Accounting/Finance teams regarding a variety of issues impacting government pricing.
Total 7+ years of progressive, related industry experience.
- 4-7 years prior experience in Government Pricing OR a related field such as finance, accounting, Medicare/Medicaid (with strong analytical skills)
Candidates MUST be able to calculate some of the following (not all but most): AMP, Best Price, URA, PHS, non-famp, IFF, ASP, FCP, and Annual NFAMP. Government pricing calculations knowledge is required. Candidates must know how to process rebates, understand Medicaid claims. Must be familiar with evaluating fee for service, fair market value, and familiar with federal and state regulations. This is required.
- Understanding of current government pricing rules, regulations, and calculations
- Must be able to identify potential problems, conduct analysis and use judgment to determine if problem exists as well as offer up potential solutions.
- Highly analytical, able to analyze, interpret, and convey data and its commercial impact
- Ability to decipher calculations to determine key causes of variances.
- Strong communication skills and ability to communicate effectively to all levels of the organization.
- Enthusiastic about continuing to learn and gain subject matter expertise in Government Programs/Pricing Compliance.
- Experience working in mandated deadline environment
- Ability to work in a team setting.
This is an opportunity to join our select team that is already leading the way in the Pharmaceutical/Biotech industry. Apply today and learn more about Regeneron’s unwavering commitment to combining good science & good business.
To all agencies:
Please, no phone calls or emails to any employee of Regeneron about this opening. All resumes submitted by search firms/employment agencies to any employee at Regeneron via-email, the internet or in any form and/or method will be deemed the sole property of Regeneron, unless such search firms/employment agencies were engaged by Regeneron for this position and a valid agreement with Regeneron is in place. In the event a candidate who was submitted outside of the Regeneron agency engagement process is hired, no fee or payment of any kind will be paid.
Regeneron is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, disability status, protected veteran status, or any other characteristic protected by law.