Remarks: The Director of Contract Operations has responsibility for the internal management of Medicaid contracting, commercial contracting and PHS/VA government contracting. This position ensures commercial (i.e. GPO, Medicare, Managed Care), Medicaid (i.e. Federal, SPAP, Supplemental) and Government (i.e. PHS, FSS, VA, TriCare) contracts are accurately entered and maintained for various market segments in the Contract Operations systems to ensure accurate data availability for flexible and meaningful management reporting and rebate/chargeback adjudication. The Associate Director/Director of Contract Operations is responsible for:
- The Management of the Commercial Rebate, Medicaid Rebate, Chargeback, and Membership Departments.
- The proper evaluation and interpretation of contracts to ensure payments are made accurately and timely as per the terms and conditions of the contracts.
- The analysis and resolution of disputed claim data.
- The processing of submissions in a timely and accurate fashion, which includes the research and reconciliation of exceptions/errors and the communication with external stakeholders in the reconciliation process.
- The collaboration with internal business teams (Government Pricing, Contract Management, Pricing Analytics, Account Management, Accounting, Finance, IT) to ensure transaction, exceptions/errors, and deductions are processed and resolved accurately and timely.
- The ability to test and understand the functionality of the Contract Operations system and to understand the interrelationships between the various functional modules.
- The knowledge of Sarbanes-Oxley requirements.
- The adherence to all company and departmental policies and procedures.
- The knowledge of Generally Accepted Accounting Principles including a strong understanding of accrued liabilities.
- The ability to analyze and interpret financial documents and to implement industry standard and develop specific tests to isolate high potential items.
- The ability to lead the implementation of continuous improvement initiatives and all upgrades and enhancements to Contract Operation and Government Pricing systems. Proactively identify potential issues and inefficiencies that arise in the Government Pricing an Contract Operations department and offer recommendations and solutions. Partner with IT, systems vendors and consultants to design and implement system fixes and enhancements
Essential Functions:
- Provide effective communication and recommendations to the Finance, OCG, Legal and senior management to improve the performance of the organization.
- Display leadership throughout the organization and lead with excellent communication and interpersonal skills and demonstrate effectiveness at working in a highly matrixed environment.
- Develop an environment that motivates employees to excel and the ability to manage and mentor professional and technical staff. Manage department to obtain the highest level of performance and to ensure that departmental activities are executed with the highest efficiency and compliance possible.
- Ensure timely execution of all components of Contract Operations in a team-oriented approach and to provide clear and open communication to team members.
- Solid understanding of the pharmaceutical industry and the various channels of distribution and sales agreements. Possess knowledge in Managed Care, Medicare, Medicaid, PHS, FSS, VA, TriCare, and other market segments to accurately interpret contracts for these businesses.
- Strong analytical skills and ability to negotiate difficult settlements.
- Actively participate in monthly/quarterly legislative pricing calculations and actively participates in Best Price and Monthly/Quarterly AMP functions.
- Evaluate and modify current processes and procedures and recommend improvements to enhance productivity. Lead team in developing SOPs and templates to ensure standardization and effectiveness of business processes.
- Responsible for any projects, requests, changes in business practices, or systems changes including (but not limited to) restatement of quarterly pricing data, commercial contracting initiatives, analysis of reported data (e.g., trends, market analysis, environment analysis, supplemental rebate analysis).
- Provide insight into customer trends and recommends strategic and tactical plans to increase sales.
- Manage data from internal sources to assess performance.
- Utilize controls to ensure revenue opportunities are identified and performance issues are addressed.
Minimum Education, Experience, Knowledge and Skills Required:
- Bachelors degree with 7-10 years experience
- Minimum seven years commercial contracting & compliance experience related to pharmaceutical industry.
- Excellent leadership/management skills.
- Ability to manage large projects and provide guidance/training to direct reports and others in the department as needed.
- Excellent written and oral communication skills, with writing ability to meet legal requirements and standards.
- Ability to communicate effectively and maintain effective working relationships.
- Knowledge and experience in common industry software programs (i.e. CARS/IS, ModelN, ContractSphere, Oracle, etc.).
- Strong understanding of business financial management and sales analysis.
