Averitas Pharma
We strive to enable people with pain to live and feel more like their true selves.
Director, Pricing & Contracting
Location
United States
Posted
137 days ago
Salary
$230K - $255K / year
Seniority
Lead
Bachelor Degree10 yrs expEnglish
Job Description
• Develop and execute innovative contracting options that produce and maintain appropriate brand access, data access and brand profitability across Averitas product portfolio
• Manage the contract development, execution and maintenance of commercial, pharmacy and medical benefit agreements to support PBM/GPO like entities, Medicare Part D, Medicare Advantage, Medicaid, and PPA contracts
• Monitor price reporting for Average Sales Price (ASP) and CMS reimbursement methodologies in support of medical benefit agreements
• Monitor implications to Gross to Net (GTN) to support accurate forecasting and minimize fluctuation implications on revenue
• Responsible for analytic modeling to support requests for proposals (RFP)s
• Facilitate the contract negotiation process by analyzing customer contract redlines, and preparing responses for both internal discussions and external negotiations
• Perform timely and accurate calculation, authorization, payment and tracking of contractual rebates, chargebacks and fees
• Work with cross functional partners to measure ROI on post deal analytics
• Perform all necessary tasks to establish and maintain our federal and state contracts and reporting requirements: Adhere to federal submission deadlines and requirements
• Manage the Medicaid and Medicare rebate operations, including monthly and quarterly CMS pricing compliance, internal pricing analysis, systems development and dispute resolution
• Manage quarterly and annual VA pricing compliance and oversee administration of the VA Federal Supply Schedule contract including annual Public Law process
• Manage any price reporting functions under state law with support from our vendors
• Prepare and submit Requests for Modifications (RFMs) as necessary
• Oversee the development of pricing strategies for new indications and or new products
• Manage the notification process for all wholesale acquisition cost and contract pricing action changes to contracted and third-party vendors
• Support the development and maintenance of policies and standard operating procedures (SOPs) for rebate management, pricing actions, etc. to ensure compliant operations
• Aid in forecasting to support the accrual process for financial close in support of earnings projection objectives
• Ensure all federal and state rebates, e.g., Medicaid, Coverage Gap/MDP, etc. payments are made and tracked accurately and in a timely manner
• Maintain ongoing communication with the finance, legal and third-party vendor to monitor and analyze pricing and/or discounts that may affect Best Price and government price reporting calculations
Job Requirements
- Minimum 10 years’ experience in the healthcare industry
- Minimum 5 years’ experience in contract administration or operations, data analysis and interpretation; prior market access experience preferred
- Strong background in contract negotiations with vendors, payers, providers, specialty pharmacies, and/or distributors
- Proven experience with government pricing programs (e.g. Medicaid, Medicare, 340B, VA/DoD) and commercial (medical and pharmacy benefit) contracts
- Knowledge of US pricing and reimbursement structures required
- Detailed knowledge of health plans and PBM decision-making processes
- Demonstrated understanding of health economics
- Demonstrated ability to interact with all levels of management as well as field sales, marketing, medical affairs, regulatory and vendor partners
- Ability to maintain an independent and objective perspective while developing and maintaining a strong partnership with client organizations
- Ability to work with and deliver on deadlines while managing multiple projects and priorities with limited supervision
- Intrinsic drive and motivation to achieve success
Benefits
- Long-Term Incentive Plan (cash plan) of 25% base salary
- Annual performance bonus target of 25% base salary (subject to meeting plan requirements)
- Comprehensive health benefits (employer funded)
- Unlimited vacation time
- 401k plan (subject to change or modification from time to time)
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