Otsuka
Director, Government Pricing
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Job Description
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.
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