Director, Government Pricing Operations (Remote)

Job Description

Job Description:

Vertex Pharmaceuticals Inc. Position Description

Job Title:  Director, Government Pricing Operations
Department: U.S. Market Access – Access Operations & Analytics
Location: Remote Eligible
Reports To: Senior Director, Price Reporting

Job Description:

The Director, Government Pricing Operations is a key leadership role within Vertex’s U.S. Market Access- Access Operations and Analytics team. This individual will lead government pricing (GP) analysis, calculations, and reporting, ensuring compliance with federal and state requirements. The role is also integral to the company’s readiness for product launches across multiple therapeutic areas and the evolving complexity of pricing regulations.

This individual will manage a team of GP analysts, collaborate cross-functionally, and serve as a subject matter expert in government pricing methodologies, operations and systems.  

Key Responsibilities:

Government Pricing Operations & Compliance

• Lead the execution of GP calculations and submissions for all federal programs, including Medicaid, Medicare, 340B, and VA/FSS.
• Ensure accurate and timely calculation of all mandatory government pricing reports, including AMP, BP, ASP, nFAMP, PHS/340B, and FCPs.
• Oversee system reconciliations between the government pricing platform and general ledger.
• Oversee pricing compliance activities, including monthly and quarterly submissions to CMS, HRSA, and FSS, as well as annual processes for Public Law and SAM.gov.
• Knowledge of bundling, discount reallocation and price protection, including calculation impacts.
• Understands the end-to-end requirements and data sources needed for GP calculation processes, and is experienced in validation, trouble-shooting data issue from multiple sources/systems. Manages any data issue resolution timely.
• Knowledgeable on bundling, discount reallocation, Bonafide services fees, and price protection impacts.
• Maintains controls and documentation to support SOX compliance and audit readiness.
• Interpret and implement updates to CMS guidance, federal regulations, and industry standards.

Leadership & Team Management

• Direct day-to-day activities including management and professional development of three government pricing analysts, ensuring high performance and accountability.
• Review and approve pricing calculations, analyses, and reports to ensure accuracy and compliance.
• Provide guidance on complex data or operational issues and escalate when necessary.
• Keep the team informed of internal and external developments impacting government pricing strategies and execution.
• Foster an environment of compliance, innovation, and continuous improvement.

Cross-Functional Collaboration

• Partner with internal stakeholders (e.g., Accounting, Trade Operations, Chargebacks & Rebates, Legal, and Data & Technology Engineering) to integrate pricing data and ensure consistent operations.
• Support commercialization and launch readiness for new products by aligning order-to-cash systems, maintaining essential GP frameworks and calculation matrices, program access and communication requirements for launch pricing.
• Collaborate with DTE implementation teams to design, test, and deploy IT solutions supporting pricing calculations and reporting.

Process Improvement & Strategic Planning

• Lead proactive identification and implementation of strategic enhancements to government pricing systems and operational workflows.
• Develop, implement, and maintain policies, SOPs, and control frameworks to ensure efficient and compliant pricing operations.
• Recommend and drive process improvements, system enhancements, and automation to optimize pricing operations.
• Participate in special projects, audits, and assessments as a key representative for Government Pricing.

Qualifications:

• Bachelor’s degree in Finance, Accounting, Information Systems, Economics, Law, or a related field required; MBA preferred.
• Minimum of 8 years of direct experience in government pricing, financial operations, or pricing compliance for state and federal healthcare programs.
• Experience with rare disease therapy launches