Director, Government Pricing

Job not on LinkedIn

🔥 1 minute ago

🇺🇸 United States – Remote

💵 $150k - $200k / year

⏰ Full Time

🔴 Lead

👔 Director

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MediSpend

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

💼 Consulting

📋 Compliance

Healthcare • Consulting • Compliance

MediSpend is a leading provider of compliance solutions tailored for life sciences companies. With a focus on enhancing transparency and minimizing risks, MediSpend offers a comprehensive suite of end-to-end solutions that streamline compliance processes across entire organizations. Its offerings include HCP engagement, KOL management, data management, transparency reporting, and third-party due diligence, among others. By providing real-time data analytics and a centralized view of compliance data, MediSpend enables stakeholders to identify risks and execute strategic initiatives effectively. The company empowers life sciences entities to grow their businesses while staying compliant with diverse global reporting requirements, such as the Sunshine Act and Open Payments in the United States.

📋 Description

• Personally perform complex calculations, variance analyses, and historical corrections across AMP, Best Price, URA, PHS/340B ceiling price, ASP, NFAMP, and FCP. • Develop and approve calculation methodologies and reasonable assumptions jointly with the Senior Director. • Interpret CMS Medicaid Drug Rebate Program regulations and guidance. • Determine transaction eligibility and treatment across AMP, Best Price, ASP, and NFAMP. • Own program-level positions and approve submissions for Medicare Part B, Part D, and VA/FSS programs. • Lead historical recalculation and remediation engagements end to end, including CMS change requests and resubmission approval. • Review bona fide service fee eligibility and fair market value support in partnership with Legal. • Monitor CMS, HRSA, and VA policy developments and translate requirements into calculation, reporting, and system changes. • Review and approve client-ready deliverables across all programs. • Establish a tiered, risk-based review framework and maintain documented sign-off records. • Monitor deadlines, resolve capacity constraints, and investigate root causes of client-facing errors. • Manage, coach, and develop Government Pricing Analysts and Team Leads. • Develop additional qualified approvers and program leads. • Maintain regulatory position logs, methodology documentation, SOPs, and review criteria. • Lead technical development, performance management, succession planning, and hiring. • Serve as a senior escalation point for complex client issues and disputed results. • Lead quarterly business reviews and explain calculation outcomes and rebate liability exposure to client stakeholders. • Support Sales and Account Management with scoping, statements of work, and level-of-effort estimates. • Advise clients on Medicaid inflation penalty exposure and proposed WAC increase impacts. • Establish and monitor KPIs and service-level targets, including timeliness, exception and rework rates, backlog aging, and team utilization. • Manage project budgets and account-level cost to serve. • Build the business case for automation and partner with IT, Product, and Development on government pricing logic, configuration, and calculation testing.

🎯 Requirements

• Bachelor's degree in Finance, Accounting, Business, Economics, Healthcare Administration, or a related field; advanced degree a plus. • 10+ years of pharmaceutical government pricing experience, the majority gained inside a manufacturer or in a role directly accountable for manufacturers' reported prices and certifications. • Personal, hands-on ownership of AMP, Best Price, and URA methodology and calculation — not oversight alone. • Deep expertise in the Medicaid Drug Rebate Program, PHS/340B ceiling price, and federal pricing requirements. • Record of establishing, documenting, and defending reasonable assumptions and regulatory positions that withstood audit or client scrutiny, including multi-period historical recalculations and corrected CMS submissions. • Working knowledge of Medicare Part B ASP reporting and certification, the Part D Manufacturer Discount Program, and VA FSS 65IB contracting, NFAMP, FCP, and IFF obligations. • 3+ years leading analysts or technical staff, with a demonstrated record of raising people's technical capability. • Experience with government pricing platforms such as iContracts, Model N, IntegriChain, EVERSANA, Vistex, or comparable solutions. • Advanced Excel skills. • Ability to manage competing priorities in a deadline-driven environment, with an uncompromising commitment to accuracy and compliance. • Preferred: Managed services, consulting, or outsourced provider experience supporting multiple pharmaceutical manufacturers. • Preferred: Experience in a smaller or scaling organization where process, documentation, and controls had to be built rather than inherited. • Preferred: Experience building a methodology or regulatory position library used by a team, and establishing KPIs, service-level targets, and quality metrics. • Preferred: Experience advising on line extension, 5i treatment, authorized generic relationships, class of trade, and UPPS corrections. • Preferred: Working knowledge of Public Law pricing compliance and Trade Agreements Act (TAA) requirements. • Preferred: Experience applying AI or automation tooling to regulatory research or calculation workflows, and working proficiency with SQL, Power Query, Alteryx, or comparable data tooling.

🏖️ Benefits

• Merit-based compensation – Competitive base salary plus bonus • Work from anywhere – Roles are open to candidates located anywhere in the US (United States) • Unlimited PTO (Paid Time Off), including Paid Holidays and Sick Leave • 401k+ Match • Comprehensive health, dental, and vision insurance • Paid Parental Leave • Health and wellness perks including life & disability insurance, healthcare funding options like FSAs (Flexible Spending Accounts) and HSAs (Health Savings Account), Dependent Care, an EAP (Employee Assistance Program) program, discounts, Learning and Development • Limited travel may be required for occasional team meetings, training sessions, or business events • Reasonable accommodations will be provided in accordance with the Americans with Disabilities Act (ADA) and other applicable laws

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