State Medicaid Manager - Government Programs

The Opportunity:

With Government entities being Genentech’s largest customer, the Government Programs (GP) team within Channel and Contract Management (CCM) is responsible for managing the complexities of government pricing to enable patient access through the federal drug programs (Medicare, Medicaid, 340B, Veterans Affairs and Department of Defense Federal Supply Schedule & TRICARE). GP does this by reporting accurate pricing calculations, paying government rebates and providing strategic value to its managed care partners.

Collectively, these efforts help Genentech meet evolving business needs and foster a culture of compliance around government programs. The State Medicaid Manager will lead and manage moderate to unusually complex state and supplemental Medicaid Rebates in compliance with strict accuracy targets, timelines, laws and regulations, GP methodology and all applicable Genentech policies and guidelines. This position may participate in and lead various cross-functional teams and projects, assess and recommend solutions and communicate to relevant stakeholders and management.

Responsibilities:

• Manage the end-to-end Medicaid Rebates process and applicable administration activities for all assigned state government contracts and programs. Act as lead subject matter expert for others 

• Manage and operationalize end-to-end Medicaid Supplemental Rebate Contracting process, including validation of the Medicaid formulary as required and necessary communication with internal and external stakeholders

• Develop and implement standard department reports, scorecards, metrics, customer business reviews, compliance and other ad hoc reporting

• Identify and communicate impacts to Medicaid rebate pricing and other related programs and share specific analysis where interdependencies between calculations and claims exist 

• Lead cross-functional activities related to accurate and compliant execution of the 340B pricing program and other revenue leakage initiatives

• Lead efforts with Finance and others to track and reconcile customer rebates to ensure adequacy of financial reserves, data integrity issues are resolved and penalties are avoided

• Identify business-process automation use cases, support the team's ongoing work with the automation team to develop the solution, translate back the scenarios to the business team, implement and enhance the solutions.

• Function as a subject matter expert and technical resource on rebating systems/tools.

• Collaborate internally and cross-functionally to share ideas, common solutions, and best practices thereby harmonizing solutions and developing repeatable, scalable best practices

Who You Are

• Bachelors Degree (or equivalency as demonstrated by at least 8 years of related work experience)

• A minimum of 3 years’ work experience in government programs or related analytics

• Demonstrable knowledge of the different state and federal government agencies that purchase pharmaceutical/biotechnology or related industry products

• Demonstrable knowledge of systems and reporting mechanisms that support contract administration particular to the pharmaceutical/biotechnology or related industry

• Demonstrable decision making skills, ability to work collaboratively in a team structure, as well as ability to problem solve and troubleshoot issues by self with minimum guidance

• Data management skills and ability to analyze information to properly communicate relevant data to both internal and external stakeholders

• Excellent grasp/understanding of the pharmaceutical/biotechnology industry, Genentech's overall business model, specific brand positioning, and the surrounding marketplace

Preferred Qualifications

• Degree in areas related to General Business, Finance, Public Policy disciplines

• MBA or other related graduate-level degree

• Knowledge of Qlikview, Business Objects and Salesforce cloud.

• Demonstrable/expert knowledge of the current policies and guidelines that affect government programs, pricing and payment adjustments (e.g., Medicare, Medicaid)

• Strong knowledge of systems and reporting mechanisms that support contract administration particular to the pharmaceutical/biotechnology or related industry

• Previous experience in other functi