Manager of Chargeback Operations

Role Summary

The Manager of Chargeback Operations is a critical role reporting to the Associate Director, Chargeback Operations within the Market Access Contract Operations team. It combines data, process optimization, automation, and innovation to build new functional capabilities while ensuring accuracy and compliance. The role is remote and involves cross-functional collaboration with senior leadership to mitigate revenue leakage and expand membership management into new disease areas.

Responsibilities

• Play a critical role in managing membership for 340B, GPOs and additional strategies across multiple therapeutic areas, collaborating with 3PL, Trade & Distribution, Accounting, and DTE to develop policies, processes, system requirements, and SOPs.
• Partner with Government Pricing, Contract Operations, Payer Accounts and Legal to provide insights during contracting strategy design, contract development, negotiation, and operationalizing strategies.
• Stay current with federal regulations impacting chargeback and rebate adjudications; assess and communicate potential impacts to current or future processes.
• Oversee and optimize the membership management process, ensuring accuracy and compliance with regulations and internal SOX controls; lead for SOX-related, internal, and external audits.
• Understand the 340B Drug Discount Program and membership eligibility requirements to safeguard against diversion, duplicate discounts, and incorrect chargebacks submissions.
• Support internal assessments of contract pharmacy arrangements in alignment with 340B Contract Pharmacy Policy terms and conditions.
• Analyze purchase data and investigate chargeback anomalies related to eligibility, NDCs, contract pharmacies, and potential duplicate discounts.
• Responsible for contract operationalization, including Model N/Revitas contract setup, membership management, and customer payment administration; establish processes to translate contract terms into operational solutions.
• Manage contract and membership compliance, including timely verification of eligible members/plans and validation of customer policies to confirm rebate and chargeback eligibility.
• Respond to, research, and address customer discrepancies and disputes to determine eligibility based on contractual terms within specified timeframes; deliver customer-centric communication in disputes.
• Support strategic assessments of automation or digital solutions to critical processes; collaborate with DTE to improve system capabilities and seek process efficiencies.
• Model N/Revitas Chargeback module SME, establishing complex calculations within systems or manual spreadsheets if needed; partner with DTE to manage enhancement backlog and troubleshooting.
• Research and interpret complex data to evaluate performance, identify trends and insights; experience validating chargebacks, monitoring program utilization, and assisting with compliance and contract management.
• Determine Classes of Trade based on eligibility rules and assess program compliance.

Qualifications

• Required: Bachelor’s degree in business or a technological discipline (e.g., Engineering, Computer Science, Accounting, Statistics, Economics, Finance).
• Required: 8+ years US pharmaceutical industry experience with increasing responsibilities in contract operations, contract management, financial analysis, membership management, processing, and payments to FSS, Wholesalers, GPOs and IDNs.
• Required: 5+ years’ experience with managed care contract admin technology (e.g., Model N, EDI, GPOs).
• Required: Experience with GPO rosters and internal discount programs; working knowledge of the 340B program and government regulations.
• Required: Proven ability to work in a fast-paced, complex, customer-focused environment; ability to build collaboration and drive problem-solving within and across teams; ability to influence stakeholders through effective communication; strong analytical and solutions-driven mindset; high attention to detail.
• Required: Proficiency in Government Pricing calculations, Medicaid, Medicare and FSS; ability to navigate ambiguity and manage through complexity; excellent organizational skills.
• Required: Effective communicator capable of influencing decision-makers through incisive analysis and persuasive communication; proficient in Microsoft Excel, PowerPoint, and Word.
• Preferred: MBA, MPH, or a Master’s in a quantitative discipline.
• Preferred: 8+ years in biotech/pharmaceuticals in a quantitative role in Managed Markets/Commercial/Finance/Investment Banking, or 3+ years in biopharma consulting post-MBA/PhD with direct reports and quantitative decision support experience.
• Preferred: Project management experience and familiarity with project management techniques.
• Preferred: US product launch experience; cell and gene therapy experience a plus; contract strategy implementation experience; value-based contract implementation experience.
• Preferred: Experience in working with senior leadership to support financial forecasting and analytics, and/or commercial launch planning; knowledge of AI/ML tools, SQL/Alteryx, blockchain technology and data visualization tools.