Director, Pricing, Contracting, and Government Program Operations

Summary

Join Scholar Rock, a biopharmaceutical company, as the Director/Senior Director, Pricing, Contracting & Government Program Operations. Reporting to the VP, Commercial Finance and FP&A, you will lead pricing, contract management, and government price reporting operations. Responsibilities include managing the pricing approval process, developing and executing contracts with payers and managed markets, and overseeing government pricing operations through a vendor. You will also develop and maintain reporting, manage disputes, and ensure compliance. This role requires extensive experience in pharmaceutical/biotech pricing and contracting, strong analytical skills, and the ability to manage multiple priorities. The position may involve managing a team in the future.

Requirements

• Understanding of the pharmaceutical business
• Understanding of the overall economics of a pharmaceutical manufacturer, its customers and stakeholder partners
• Clear understanding, with a proven track record working in, all aspects of pharmaceutical/biotech pricing & contracting, including laws and regulations, payer segments, purchase based customers, government pricing statutes and obligations, and the impact of other areas on pricing (ex: Trade & Distribution.)
• Demonstrated strategic mindset, with the ability to piece together disparate elements impacting price, customer decisions, competitive landscape, etc. to arrive at a cohesive decision/recommendation
• Working knowledge of US accounting rules, gross to net reporting, and overall sound finance acumen
• Proven ability to work independently in a diverse and challenging environment, successfully handling multiple priorities and delivery against tight deadlines
• Demonstrated ability to manage through ambiguity and drive to performance
• Additionally, this position will require analytic skill to solve problems and resolve issues within and external to the organization, and to work closely with data, vendors, customers and contracts to determine the proper resolution
• Minimum of four-year college degree preferably with business or finance concentration
• Minimum 8 years (minimum 10 preferred) pharma, biotech experience
• Minimum 5 years’ experience with pricing and contracting in the pharmaceutical/biotech market, including a minimum of three years in a pricing function, and demonstrated experience with contracting in commercial, Medicare, Medicaid, FSS, and PHS
• Previous experience managing people both in functional line management, and people and projects in a matrix environment
• Experience working with or in the realm of the calculation and reporting of mandated government prices

Responsibilities

• Develop and manage company governance decision making process for all WAC and contract price approvals
• Work alongside Market Access colleagues to drive the strategic thought process around pricing (both gross and net) for the entirety of the organization, and articulate rationale for strategic decisions around price
• Direct company activities to develop and approve product WAC price and WAC price change recommendations, including the lifecycle management (market evolution, label changes, etc.)
• Assist in development of Market Access net price strategies to support brand and segment initiatives, including contract strategy and market segment strategies
• Work closely with VP, Market Access and Head of Trade & Distribution to ensure appropriate disclosure of pricing, accurate price communications to stakeholders, and support for other functions as it relates to pricing and contracting
• Partner across the Commercial and Finance organizations to ensure an aligned approach to pricing, pricing changes and the resultant financial impact
• Manage the drug listing process
• Lead and/or manage, as appropriate: Contract Development process for all payer segments
• Assist Legal in developing and maintaining standard contract template terms and conditions
• Assist Account Managers in negotiating requested changes to standard terms and conditions
• Assist Legal with managing internal contract approval process to review, approve and sign contracts for formal execution
• Develop and execute standard internal and external communications of executed contracts
• Contract Setup and execution in CGPV systems: Review and approve contract setup in CGPV contract management system to include effective dates, eligible products and plans, products, pricing and rebate calculations
• Review and approve rebate eligibility for plans and benefit designs as outlined in contract terms and conditions
• Contract payment process: Develop standard reports and information to support CGPV rebate payments
• Perform preliminary review and approval of rebate payment
• Assist in final rebate review and approval
• Develop standard report formats for contract and rebate payment information: Quarterly contract performance reports
• Quarterly product business reviews
• Dispute Resolution reports
• Government Pricing & Reporting: Oversee and/or manage staff towards: The operations of the designated CGPV to ensure accurate and timely calculation and reporting of mandated federal (including 340B and Federal Supply Schedule / Federal Ceiling Price) and state government price points (Medicaid)
• Develop and maintain communication and feedback loop to support monthly, quarterly, and annual government price calculations
• Develop and execute monthly, quarterly, and annual price calculation reviews to include known system changes, policy and procedure changes, and pricing and contracting changes
• Manage required certification of mandated government price points by C-suite or delegate
• Direct activities to ensure accurate and timely delivery of required data to CGPV for all government mandated pricing programs
• Develop and execute quarterly business reviews and annual reviews of vendor operations
• Manage dispute resolution process for any disputed rebate claims
• The development of standard report formats for government price reporting. Monthly / quarterly / annual price review reports
• Government price impact report (ex: ASP)
• Best price / lowest contract price report
• The resolution of CGPV and/or government questions and issues for calculation and reporting of government price points
• Manage government information requests or audits of government price reporting
• The alignment with CGPV to ensure training and education of relevant parties in the organization for government price reporting requirements, changes in legislation, and needed policies and procedures
• Own the state government price reporting requirements and work with the CGPV to ensure timely and accurate reporting; interface and alignment with Corporate Compliance is required
• Assist in development of rebate accrual forecast, including detail assessment of the required gross to net reporting, and review of rebate actual payments against forecast
• Support special projects as needed
• Position is expected to potentially have one staff/manager level reporting to it in the future

Preferred Qualifications

• MBA or MSA preferred
• Prefer experience working in managed markets or other market access functions