Patient Support Vendor and Program Operations Manager (Contract)

Vertex PharmaceuticalsBoston, MA
Hybrid

About The Position

Vertex is seeking a Manager to join the Patient Support Operations & Vendor Management Team within the US Patient Support Center of Excellence. This team supports Vertex North America Commercial’s Patient Support organizations, which assist patients living with Cystic Fibrosis, Sickle Cell Disease, Beta-thalassemia, and Acute Pain. The Patient Support Operations & Vendor Management Team oversees patient support vendors, including those managing financial assistance programs, benefits investigations, prior authorizations, and travel programs. The team also collaborates with Specialty Pharmacy partners to ensure a seamless patient experience.

Requirements

  • Bachelor’s Degree and 3+ years of experience in the healthcare/pharmaceutical industry.
  • Strong understanding of payer structures (Commercial, Medicare, Medicaid, etc.) and their impact on patient support.
  • Experience in pharmaceutical access, reimbursement, commercial systems, and analytics.
  • Intellectually curious with a continuous improvement mindset and high customer service aptitude.
  • Ability to work in a fast-paced environment, multitask, and prioritize workload.
  • Strong attention to detail, communication, presentation, and interpersonal skills.
  • Proficiency in Salesforce CRM and reporting tools.

Responsibilities

  • Lead weekly stand-up calls with in-network Specialty Pharmacy Program Teams and identify trends and insights to report back to Patient Support Team
  • Oversee day-to-day activities interactions with our specialty pharmacies including providing technical expertise for pharmacy questions and escalations & managing our pharmacy outreach process
  • Manage CRM SP profiles & internal reference guides, and trainings/roll out related to launch, new initiatives and pharmacy operations
  • Partner with PSSs for 340B support for 340B pharmacies/centers reporting data
  • Prepare for Quarterly Business Reviews (QBRs) and status meetings with in-network pharmacies, provide feedback on pharmacy service levels, and provide insights into pharmacy trends and issues that affect our team and patients
  • Monitor data quality, create and maintain dashboard, & provide ad hoc reporting, including seasonal coordination support
  • Identify and drive process improvements & innovative solutions/analytics to make the patient experience better, and our team more efficient
  • Oversee and support patient transitions to new pharmacies due to insurance/PBM changes
  • Partner with internal Managed Markets Specialty Pharmacy Engagement Team to ensure alignment on trends, insights and SP initiatives to support patients, HCPs and PSSs.
  • Oversee and manage daily/weekly escalations, and ensure timely resolution
  • Collaborate with Access and Reimbursement team to address outstanding issues.
  • Identify and implement system improvements to reduce redundant escalations.
  • Monitor financial assistance issues and work with network pharmacies to resolve barriers to patient access.
  • Monitor Patient Support Team (PST) Specialty Pharmacy escalations related to PSS/Patient/Caregiver/HCP challenges, identify and communicate trends and work closely with the team to find the root cause and create plans of action for resolutin
  • Develop new and maintain existing data reporting for insight generation
  • Work with Systems team on continuous improvement for internal and external reporting and trend monitoring
  • Proactively monitor data quality, maintain dashboards and provide daily, weekly, quarterly and seasonal and ad hoc reporting to the Specialty Pharmacies
  • Co-lead a “Rep” team of Patient Support Specialists to develop processes, share best practices and train teammates.
  • Actively contributes to routine team meetings, business reviews and workshops.
  • Proactively identifies challenges and offers up process improvements and solutions.
  • Act in compliance with all laws, regulations and Vertex policies.
  • Complete all Vertex-U requirements on time
  • Other responsibilities as assigned

Benefits

  • compensation, medical benefits, fringe benefits and other terms and conditions of employment shall be presented by the third-party agency partner upon offer.
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