Director Government Pricing & Compliance
My client is a fast-growing pharmaceutical company located in the western suburbs of Boston, MA. They are creating innovative therapies that help transform people’s lives, while playing an increasingly active role in the future of global health. They strive to contribute to society through innovative application of science and medicine for the betterment of healthcare worldwide.
Their culture is collaborative, very positive, high energy, enthusiastic people. It’s a culture where you can be noticed, advance, and make a difference, to the company, and to the patients they serve. They are looking, not just for someone who can do the job today, but for someone who can grow to become one of their organization's future leaders. If you are curious, passionate, and determined to make a difference, this could be the organization for you!
I am seeking a Director of Government Pricing & Compliance to join their Commercial team. You will have 2 direct reports but will be building your team up to 5-6.
- 9+ years pharma experience, with 7+ years working with state and federal pricing and rebate programs
- Knowledge of government pricing and rebating calculations required, including experience in managing Gov’t Pricing restatements for recalculations of prior reported periods
- Experience in, and ability to learn standard industry systems environment, specifically, ORACLE ERP, Revitas/Medicaid and Revitas/Commercial
- Experience with AMP, Best Price, FSS, PHS, CPI-U, Non-FAMP, DOD, VA, etc.
- Prefer previous management experience but will consider someone ready to manage
- Ability and willingness to roll up your sleeves and get your hands dirty
- Must be authorized to work for any employer without sponsorship
The Director of Government Pricing and Compliance will direct and coordinate all tactical and strategic activities for the Government Pricing and compliance function.
- Ensure accuracy and adequacy of the overall financial liability resulting from the company’s government contracting process, primarily as it relates to federal and state Medicaid and Medicare contracting
- Calculation of all Government Pricing required and submission to appropriate regulatory agency including AMP, Best Price, Non-FAMP, FSS, PHS, DOD, VA etc.
- Ensure that all government rebate calculation methodologies are following existing legislation and are in conformance with the company’s internal procedures. Verification of the accuracy and integrity of all calculations and methodologies. Reporting pricing and discounting to federal and state agencies and managing adjustments and/or dispute resolution
- Determination of all sales and utilization for all regulated markets as applicable to the various government pricing calculations
- Implementation and utilization of Revitas government pricing system for all GP calculations.
- Manage GP steering committee and ensure review and update of all applicable GP policies as it relates to GP legislation
- Ensure SOX Compliance
- Future projections of relevant pricing for forecast purposes
- Developing and issuing appropriate reporting for key managers and other required users of the information
- Interact on regular basis and exchange information and direction with the Contract Strategy & Operations team
- Interact with Legal Department on regular basis for matters related to government pricing, compliance and emerging legislation/trends
- Manage and maintain all reporting & queries used to develop various pricing requirements.
- Participate in industry training to ensure knowledge is up to date.
- Manage any required changes to the GP system necessitated by changes in legislation.
- Manage a team of 3 to 4 direct reports with Government Pricing experience/knowledge
- Working with Government Pricing Working Group to implement process improvement and compliance recommendations
- Timely calculation of Average Manufacturers Price (AMP) and Best Price (BP), Consumer Price Index (CPI-U) impact and any other required government pricing or parameters (Federal Supply Schedule, Public Health Service, CMS, or Supplemental rebates, etc.) for the purpose of determining government prices, unit rebates and revenue reserve requirements for all products reimbursed through Medicaid, Medicare, or other governmental programs. Timely calculation and submission of pricing and discounting information to state and federal agencies
- Model and ensure accuracy of the impact of government and commercial discounts, both current and proposed, on AMP, Best Price, FSS, PHS, and required rebates
- Interpret and apply all relevant legislation as required for proper compliance
- Bachelor’s Degree in accounting, finance or other applicable business discipline. MBA preferred, but not required. CPA or public accounting experience desired
- 7+ years in Pharmaceutical Industry working with state and federal pricing and rebate programs with specific experience in Medicaid and Medicare pricing and rebate administration. 9+ years overall experience in professional, operational, environment. Knowledge of government pricing and rebating calculations and requirements is essential
- Experience in, and ability to learn standard industry systems environment, specifically, ORACLE ERP, Revitas/Medicaid and Revitas/Commercial. Involvement with a multi-dimensional business system requiring extraction of data from one or more systems to a common database for reporting and analysis, is highly desired
- Experience with Microsoft office products required and knowledge of advanced Excel techniques such as pivot tables and data import are desired
- Experience in managing Gov’t Pricing restatements for recalculations of prior reported periods