Director, Government Pricing

Remote Full time

R12802

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 The director 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. Institute the appropriate GP checks for accuracy and completeness, including independent parallel government pricing calculations, validate modeling set‑up, test reasonableness of GP changes, and assess the business impact of GP updates. Reimbursement Operations This role oversees processing and payment of all government rebates and discounts, including Medicaid rebates, Medicare PartD manufacturer discount program, and inflation rebates under the Inflation Reduction Act (IRA). The team manages Federal Supply Schedule (FSS) contracts, Department of Defense blanket purchase agreements, and Medicaid supplemental agreement negotiations with state programs. Regulatory Compliance & Policy Management The director ensures compliance with evolving federal and state requirements, including state price transparency reporting, Medicare Drug Price Negotiation (MFP) under IRA, and bonafide service fee evaluations in partnership with commercial teams. This includes working closely with legal counsel (internal and external) to interpret CMS guidance and develop compliant contracting language. Strategic Responsibilities/ Cross-Functional Partnership The role requires close collaboration with Contract Operations for commercial rebate alignment, Market Access teams for government account strategy, Gross-to-Net forecasting teams for pricing impact analysis, and Pricing Committees to assess how proposals affect government price calculations. The director provides education to stakeholders on government pricing implications of business decisions through lunch‑and‑learns, annual meetings, and ongoing communications. Systems & Data Management Oversight of third‑party vendor and evaluation of technology platforms for contract management and rebate analysis and financial payments. A key responsibility is driving data visibility initiatives through Power BI dashboards and enhanced reporting to enable proactive monitoring rather than reactive analysis Dispute Resolution & Operational Excellence Managing complex dispute processes with state Medicaid agencies, particularly around 340B duplicate discounts where manufacturers have already provided discounts but states seek rebates. The director leads process improvement initiatives to reduce manual workload and free up team capacity for strategic analysis rather than transactional payment processing. Education & Experience Requirements 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, handling external audits, and presenting complex regulatory risks to senior executives. Competencies Accountability for Results - Stay focused on key strategic objectives, be accountable for high standards of performance, and take an active role in leading change. Strategic Thinking & Problem Solving - Make decisions considering the long-term impact to customers, patients, employees, and the business. Patient & Customer Centricity - Maintain an ongoing focus on the needs of our customers and/or #J-18808-Ljbffr Otsuka America Pharmaceutical Inc.