[Hiring] Director, Government Pricing @Otsuka Pharmaceutical Co., Ltd.

Role Description

The Director, Government Pricing leads all federally mandated price calculations including Medicaid Average Manufacturer Price (AMP) and Best Price, Medicare Average Sales Price (ASP), and VA Non-FAMP pricing. This includes managing quarterly and annual reporting certifications, analytics to identify pricing trends and anomalies, and ensuring data accuracy through validation processes with audit teams.

Key Responsibilities

• Government Pricing Calculations & Reporting:
  • Leads all federally mandated price calculations including Medicaid AMP and Best Price, Medicare ASP, and VA Non-FAMP pricing.
  • Manages quarterly and annual reporting certifications.
  • Conducts analytics to identify pricing trends and anomalies.
  • Ensures data accuracy through validation processes with audit teams.
  • Institutes appropriate GP checks for accuracy and completeness.
  • Validates modeling set-up and tests reasonableness of GP changes.
  • Assesses business impact of GP updates.
• Reimbursement Operations:
  • Oversees processing and payment of all government rebates and discounts.
  • Manages Medicaid rebates, Medicare Part D manufacturer discount program, and inflation rebates under the IRA.
  • Handles Federal Supply Schedule contracts and Medicaid supplemental agreement negotiations.
• Regulatory Compliance & Policy Management:
  • Ensures compliance with federal and state requirements.
  • Works closely with legal counsel to interpret CMS guidance and develop compliant contracting language.
• Strategic Responsibilities/ Cross-Functional Partnership:
  • Collaborates with Contract Operations for commercial rebate alignment.
  • Works with Market Access teams for government account strategy.
  • Engages with Gross-to-Net forecasting teams for pricing impact analysis.
  • Educates stakeholders on government pricing implications through various communication methods.
• Systems & Data Management:
  • Oversees third-party vendor and evaluates technology platforms for contract management.
  • Drives data visibility initiatives through Power BI dashboards and enhanced reporting.
• Dispute Resolution & Operational Excellence:
  • Manages complex dispute processes with state Medicaid agencies.
  • Leads process improvement initiatives to reduce manual workload.

Qualifications

• Education: A Bachelor's degree in Accounting, Finance, Business Administration; an MBA, CPA, or JD is highly preferred.
• Years of Experience: 10+ years of progressive experience in the pharmaceutical or biotech industry.
• Domain Expertise: Minimum of 5+ years directly focused on statutory Government Pricing calculations, operations, and compliance.
• Leadership: Proven track record of managing technical analyst teams and handling external audits.

Competencies

• Accountability for Results: Stay focused on key strategic objectives and lead change.
• Strategic Thinking & Problem Solving: Make decisions considering long-term impacts.
• Patient & Customer Centricity: Focus on the needs of customers and stakeholders.
• Impactful Communication: Communicate with logic, clarity, and respect.
• Respectful Collaboration: Value diverse perspectives and partnerships.
• Empowered Development: Actively engage in professional development.

Benefits

• Comprehensive medical, dental, vision, and prescription drug coverage.
• Company provided basic life and accidental death & dismemberment insurance.
• Short-term and long-term disability insurance.
• Tuition reimbursement and student loan assistance.
• A generous 401(k) match.
• Flexible time off, paid holidays, and paid leave programs.
• Other company provided benefits.