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 Part D 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 key stakeholders.
Impactful Communication - Communicate with logic, clarity, and respect. Influence at all levels to achieve the best results for Otsuka.
Respectful Collaboration - Seek and value others' perspectives and strive for diverse partnerships to enhance work toward common goals.
Empowered Development - Play an active role in professional development as a business imperative.
Minimum $186,489.00 - Maximum $278,875.00, plus incentive opportunity: The range shown represents a typical pay range or starting pay for individuals who are hired in the role to perform in the United States. Other elements may be used to determine actual pay such as the candidate's job experience, specific skills, and comparison to internal incumbents currently in role. Typically, actual pay will be positioned within the established range, rather than at its minimum or maximum. This information is provided to applicants in accordance with states and local laws.
Application Deadline : This will be posted for a minimum of 5 business days.
Company benefits: Comprehensive medical, dental, vision, prescription drug coverage, company provided basic life, accidental death & dismemberment, short-term and long-term disability insurance, tuition reimbursement, student loan assistance, a generous 401(k) match, flexible time off, paid holidays, and paid leave programs as well as other company provided benefits.
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Disclaimer:
This job description is intended to describe the general nature and level of the work being performed by the people assigned to this position. It is not intended to include every job duty and responsibility specific to the position. Otsuka reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.
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Otsuka Pharmaceutical Co., Ltd. is a global healthcare company with the corporate philosophy: "Otsuka-people creating new products for better health worldwide." In the U.S., Otsuka is comprised of two companies, Otsuka America Pharmaceutical, Inc., and Otsuka Pharmaceutical Development & Commercialization, Inc., that share a deep commitment to the development and commercialization of innovative products in the spaces of neuroscience, nephrology, and digital medicine.
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OPDC and OAPI are indirect subsidiaries of Otsuka Pharmaceutical Company, Ltd., which is a subsidiary of Otsuka Holdings Co., Ltd. headquartered in Tokyo, Japan. The Otsuka group of companies employed 34,400 people worldwide and had consolidated sales of approximately USD 14.2 billion in 2023.
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