Patient Support Vendor and Program Operations Manager

Job Description

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.

This hybrid role requires 3 days per week on-site at the Boston Seaport office and reports to the Director, Patient Support Operations & Vendor Management.

Key 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

Other Responsibilities:

• 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

Minimum Qualifications:

• Bachelor’s Degree and 3+ years of experience in the healthcare/pharmaceutical industry.
• Strong understanding of payer structures (Commercial, Medicare, Medicaid, etc.) and their…