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- Florham Park, NJ
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Sr. Manager/Director - US Managed Care/Government
The Judge Group • Florham Park, NJ
Posted 4 days ago
Job Req # 591641
Pharmaceutical Company is looking for:
POSITION: Sr. Manager/Director - US Managed Care/Government Pricing
SALARY: $155-175K + 15% Bonus
LOCATION: Florham Park New Jersey Area
EXPERIENCE: 5-7+ Years Government Pricing and Managed Care Strategy
The Senior Manager/Director , Government Pricing is responsible for oversight of COMPANY Government Pricing calculations, analysis, and submissions. This position will help serve as the subject matter expert in supporting the company’s strategy for the portfolio of products across all government payors. Additionally, this roll will manage oversight of Government Pricing including creating / updating SOPS, ensuring methodologies are compliant with SOPs, verifying calculations are accurate, and ensuring submissions are timely. This position will also be responsible for complying with all state reporting requirements including pricing and transparency requirements
- Ensure that COMPANY Government Pricing calculations are accurate, submitted on a timely basis, and are compliant with government regulations.
- Oversight and development of Analysts responsible for Gov’t Pricing calculations ensuring they are well trained and knowledgeable
- Provide historical trend and variance analysis for Gov’t Pricing results
- Ensure COMPANY SOPs are up to date and in compliance with Government Regulations; that personnel are properly trained on the SOPs; and that SOPs are properly implemented and followed
- Partner with the Contracting team to review all business cases for government pricing implications
- Ensure COMPANY complies with all state reporting requirements
- Ensure non-bona fide fees are properly assessed and reported for all Gov’t pricing submissions
- Provide impact analysis for gov’t pricing based on various pricing and contracting scenario
- Provide strategic and actionable insights to management team for the landscape changes and opportunities associated with all government channels
Serve as COMPANY’s subject matter expert on GP and reimbursement
MAJOR ACCOUNTABILITIES (Describe up to eight/ten essential responsibilities of this position including significant tasks, responsibilities and projects)
- Develops, reviews, and implements pricing methodologies in compliance with regulations published by CMS, VA, HRSA, and other applicable Government Agencies. Works with internal and external Legal counsel to ensure COMPANY complies on all Government Pricing Programs.
- Defines data requirements for pricing and reporting; supports testing processes for data integrity and updated processes.
- Responsible for the development, communication, and ongoing maintenance of Gov’t Pricing Calculations and Reimbursement SOPs, systems, processes, data, and reporting templates.
- Is responsible for the development of the Gov’t Pricing team and provides education and training to other COMPANY employees who may impact or are impacted by Gov’t pricing results.
- Leads the reconciliation of Gov’t pricing data inputs ensuring that any data integrity issues are resolved prior to the performance of any gov’t pricing calculation.
- Identifies and communicates Gov’t Pricing trends and variances to other COMPANY employees including senior management, Finance, and product management teams.
- Validates all government calculations in a timely and accurate manner including validating (as appropriate) monthly, quarterly and annual AMP, BP, PHS, ASP, NFAMP, FCP along with any state reporting.
- Continuously monitor, evaluate and improve processes for the gov’t pricing calculation functions.
- Monitor the activity of contracts to evaluate AMP and Best Price calculations impact in accordance with CMS policy.
- Directs the management of the VA Contract Life Cycle and maintains compliance with all terms and obligations of the Veterans Affairs contract
- Participate in the Executive Pricing Committee when government contracts are discussed and be the subject matter expert on how BP, AMP and Supplemental GNUPs affect pricing policy and decisions
- Provide financial analytical support to the Managed Markets’ team to optimize the profitability of contracted agreements
- Comply with all company policies and procedures