Government Pricing Compliance Senior Manager

Role Summary

Senior Manager for Government Pricing within the US Market Access department, focusing on Government Pricing (GP) and State Transparency Reporting. Leads price reporting, contractual obligations for CMS, PHS, and VA programs, and provides expertise in government pricing, policy interpretation, and compliance. Works at the intersection of policy, reporting, contracting strategy, and compliance to support patient access and business objectives. Role may be remote or hybrid/on-site in Boston, MA.

Responsibilities

• Key contributor within the Government Pricing Team with knowledge of government pricing calculations and reporting requirements (Medicaid, Medicare, 340B, FSS).
• Provide actionable strategic and tactical recommendations aligning with U.S. government payer practices, policies, regulations, and trends.
• Monitor government pricing regulations related to payer, IDN, policy, competitors, and market conditions to inform decisions affecting reimbursement and future access strategies.
• Collaborate with Market Access Contracting, Legal, and other partners on contract reviews (BFSF, FMV, Class of Trade, etc.) and Government Pricing analysis.
• Lead contract assessments of BFSF tests, ensuring four-part tests are analyzed, interpreted, and documented for compliance.
• Ensure compliance with Federal Acquisition Regulations (FARs) and the Veterans Health Care Act in meeting FSS contractual obligations.
• Establish and maintain policies and procedures supporting SOX requirements, internal/external financial reporting, and CMS Medicaid rule changes.
• Collaborate with internal and external stakeholders across functions and external Legal/consultants to support Government Pricing initiatives.

Qualifications

• Required: Bachelor’s degree in Business, Finance, Accounting, Public Policy, or equivalent; MBA or related graduate degree is a plus.
• Required: 4–6 years of experience in pharmaceutical/biotechnology or state agency with Government Pricing, Finance, or related government payer/program administration experience.
• Required: Strong knowledge of pricing and contract strategy, government pricing methodologies, and distribution channels for government and commercial customers.
• Required: Knowledge of current policies and guidelines affecting government programs, pricing, and payment adjustments (e.g., Final Rule, Proposed Rule, Inflation Reduction Act).
• Required: Experience with pricing policy research (qualitative and quantitative impact assessments).
• Required: Strong analytical skills to interpret complex data and market trends for FMV assessments.
• Required: Proficiency with Microsoft Access, Excel, PowerPoint, and Word; ability to multitask; knowledge of Model N or Revitas/Flex is a plus.
• Required: Experience reviewing commercial contracts with entities such as Specialty Pharmacies/Distributors, Wholesalers, PBMs, GPOs, or Copay vendors.
• Preferred: MBA or related graduate degree.

Skills

• Collaborative teamwork with a focus on meeting and exceeding objectives.
• High personal accountability with the ability to prioritize to drive value and compliance.
• Attention to detail and accuracy to ensure timelines and regulatory compliance.
• Strong verbal and written communication, time management, and organization.
• Self-development and contribution to the function’s knowledge base.
• Structured thinking and the ability to apply experience and emerging knowledge to problem-solving.

Education

• Bachelor’s degree in Business, Finance, Accounting, or Public Policy; MBA or related graduate degree is a plus.