Auto req ID 2287BR
Title SR GOVERNMENT AND COMPLIANCE ASSOCIATE (Tricare/NFAMP/FSS/ Pricing IFF
Job Category Business Support
Job Description Title: SR GOVERNMENT AND COMPLIANCE ASSOCIATE (Tricare/NFAMP/FSS/ Pricing IFF)
PURPOSE:

Primary responsibility for calculating and analyzing all Government mandated calculations of product pricing used for the Medicaid Drug Rebate Program and the Federal Supply Schedule agreements and related to the various components of the Medicaid Rebate Per Unit (RPU); these components include the Average Manufacturers Price (AMP), Best Price (BP), and the Consumer Price Index (CPI_U) Penalty. Also, the components of the Federal Ceiling Price (FCP) and the Other Government Agencies Price (OGA); these components include the Annual and Quarterly Non-Federal Average Manufacturers Price (NFAMP) and the CPI_U Adjustment. This also includes price reporting and calculation of the Medicare Part B Average Selling Price (ASP) and 340B Public Health Service (PHS) pricing.

Secondary focus is on managing the Medicaid Drug Rebate Program and processing and reconciling the Medicaid claims utilizing the Model N System. Participates in the administration of the Federal Supply Schedule contract with the Veteran’s Administration (VA) to include BPAs (best price) and National Contracts. Coordinates with States, the VA, Account Executives, and contract administrators and performs analyses as required.

RELATIONSHIPS:
This position reports to the Sr. Manager/Manager Government Contracts & Compliance and includes interaction with field and home office management. External relationships include Centers for Medicaid and Medicare Services (CMS), State Medicaid agencies, Pharmacy Benefit Administrators, Veterans Administration/Department of Defense customers, and field sales personnel regarding reporting and analysis needs.

ESSENTIAL FUNCTIONS:

 Government Price Reporting
• Calculation and analysis of all government pricing
requirements mandated by Public Law relating to the Omnibus Reconciliation Act of 1990, Deficit Reduction Act and the Veterans Health Care Act of 1992 to include monthly Average Manufacturers Price (AMP), and quarterly Best Price (BP), Unit Rebate Amount (URA), Public Health Service (PHS), Average Sales Price (ASP), Non-Federal Average Manufacturers Price (NFAMP), and the Federal Ceiling Price (FCP). Identifies trends and is able to explain the reasons for changes in Government pricing based on knowledge of Government contracting.
• Prepares monthly, quarterly, and annual government price reports
 Federal Supply Schedule:
• Administration of our Federal Supply Schedule (FSS) to include monitoring of negotiated Customer of Comparability (CoC) or Tracking Customer (TC) price ratios and the ability to formulate a plan to identify a new CoC or TC in an accurate and timely manner and notify the appropriate Government agency.
• Participate in the quarterly and annual price calculation process and maintain an understanding of the IMany GP System.

 Data Analysis and Government Reporting
• Responsible for data validation processes using (Excel, Access and SQL, CARS, SAS).
• Reviews and analyzes contract terms and conditions. Ensures data in the Medicaid system reflects the contract terms for accurate processing.
• Analyzes and ensures accuracy of state rebate formatted data for each level of processing.
• Prepares and provides standard contract reports (i.e., sales, rebate pricing, reconciliation) to field sales and home office management. These reports include sales and trending reports used by upper management for the purposes of strategic decision-making. These reports also include federally-mandated government sales reports that are submitted quarterly.
• Identifies and analyzes performance trends and provides recommendations to management.

 Medicaid Rebate:
• Responsible for the timely and accurate payment of Federal and State Medicaid Rebate Invoices in excess of $100 Million
• Stays up to date and applies knowledge of the Medicaid Rebate legislation including the Deficit Reduction Act, Federal, Supplemental, and individual state programs.
• Prepares/reviews quarterly Medicaid, ADAP, SPAP (State Programs), and Supplemental Invoices and ensures compliance with prescribed filing dates.
• Reviews state utilization data for reasonableness.
• Acts as company liaison, negotiating with state Medicaid agencies and Pharmacy Benefit Administrators regarding dispute resolution with a third party Consultant.
• Quantifies and accounts for dispute exposure.
• Develops and distributes quarterly analysis of Medicaid Rebate Liability
• Maintains and can be an expert in operation of Model N Medicaid Rebate Processing systems.
• Participate in the monthly, quarterly price and rebate calculation process and maintain an understanding of the IMany GP and the Model N Medicaid Rebate Systems.


 Systems Maintenance (Model N Medicaid Rebate Systems)/Contract Administration
• Formats incoming claims data (received on tape, diskette, etc.) from contract customers; ensures rebate claims data is in proper format.
• Identifies missing claims data and works with customers in gathering and obtaining this data.
• Processes rebate claim payments, ensures claims are made within the required timeframes, as stated in the contractual agreements.
• Inputs, reviews and validates, and processes.
• Responsible for proper distribution of checks and reporting to sales and rebate customers.
• Assist internal and external customers with basic questions or problems arising with contracts.


KEY SUCCESS FACTORS: EDUCATION, EXPERIENCE, KNOWLEDGE AND SKILLS
• Bachelors Degree or equivalent experience required
• 4 years related experience (financial analysis, Managed Care, Medicaid, Government Price Reporting) required
• Knowledge of the Medicaid Drug Rebate Program is desirable
• Knowledge of Federal Government Contracting and Federal Government Pricing Calculations is desirable.
• Analytical thinker capable of identifying both the depth and breadth of data required to accurately answer questions.
• Planner and forecaster savvy with recognizing trends, establishing a way forward, and able to pay attention but not get lost in details.
• Effective communicator, persuasive in support of conclusions
• Self-motivator who seeks to improve accuracy and efficiency of analytical work and business processes.
• Microsoft Excel skills at the intermediate level required.
• Intermediate proficiency in Access, Showcase Query desirable.
OTHER:
• Works within Novo Nordisk’s established policies and procedures and ensures alignment of their work to Novo Nordisk fundamentals.
• Embraces Novo Nordisk Values in spirit and actions.
• Approximately 5% overnight travel
Department SBD - MANAGED MARKETS
Job/Position Location Princeton, NJ
Job/Position State NJ
Degree Required Bachelor's Degree Required
Percent Travel 10 - 20%