Sr Analyst, Government Pricing

Job Description

Job Summary

Responsible for calculating and/or reviewing, analyzing, documenting, maintaining, and reporting price calculation submissions for federal and state government pricing programs for the following agencies: The Center for Medicare and Medicaid Services (CMS), Department of Veterans Affairs (VA), Department of Defense Tricare (DOD), and Health Resources & Services Administration (HRSA).

Primary Responsibilities

• Calculation and/or validation (with oversight) of the following price types; Medicaid Drug Rebate Program (MDRP) calculations such as monthly and quarterly Average Manufacturer Prices (AMPs), Medicaid Best Price (BP), Public Health Service 340B Program (PHS Price), Average Sales Price (ASP) and as may be needed, Department of Veterans Affairs Non-Federal Average Manufacturer Price (Non-FAMP) and Federal Ceiling Prices (FCP).
• Ensure all pricing submissions are accurately calculated, analyzed, and validated to ensure the required government pricing variables for monthly, quarterly, and annual pricing submissions are appropriately reported to various Federal and State government agencies.
• Perform detailed monthly and/or quarterly analysis of pricing and calculation components to determine root cause of variances.
• Ensure all government pricing data is properly archived and maintained to comply with all Federal guidelines and audit requirements.
• Support administration of subsidiary government pricing computations through review of deduction, return, and sales data.
• Ensure all government pricing documentation is available and accurate.
• Support testing of new software due to government pricing systems upgrades and/or changes in pricing methodology.
• Support updating and maintaining SOPs, where appropriate.
• Support other team members in government pricing work review.

Education and Experience Requirements

• Bachelor’s degree in business, science, math, or related analytical field.
• Minimum 3-5 years of industry experience in healthcare, pharmaceutical and/or medical device industry, in functions that are heavy with math, accounting, and analysis preferred.
• Minimum 3-5 years of experience working in the areas of, government pricing, rebate adjudication, contract management process/systems, document control, etc.

Necessary Knowledge, Skills, and Abilities

• Proficient in Outlook, MS Excel and MS Word; knowledge of Revitas Flex/Model N Government Pricing system or other pharmaceutical contract/rebate/membership system a plus; must possess technical skills sufficient to learn new systems, understand system functionality well.
• Solid understanding of Medicaid Drug Rebate Program and Department of Veterans Affairs pricing calculations and reporting processes; understanding of the involvement of statutory/regulatory and compliance in the government calculation process; proven understanding of current health care environment, regulations, and health care reform laws.
• Strong organizational skills and ability to manage multiple projects simultaneously; ability to adjust to changing needs within the organization and flexibility to change priorities as needed; must be able to work under strict deadlines.
• Excellent written and verbal communication skills to interact with external and internal customers; interpersonal skills with demonstrated ability to work well with others, manage work with counterpart(s) and drive towards consensus.
• Strong mathematical, analytical and critical reasoning skills; ability to analyze data and trends, to develop and/or work with flexible pricing models to rapidly facilitate complex management decision-making, address the pricing of potential risk areas, and to strategically model and present “what if” scenarios to support the proposal process.
• Excellent attention to detail with the capability to appropriately define issues and question data; to comprehend qualitative and quantitative methods to perform accurate analysis; ability to creatively think about different problems and devise pragmatic solutions to develop data into actionable information.
• Must possess a strong work ethic and a demonstrated history of adherence to policies and procedures.