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Remote

Full time

R13228

The Senior Manager, Contract Operations & Revenue Integrity is responsible for protecting and optimizing the gross-to-net (GTN) revenue for the company's drug portfolio. Operating at the intersection of contract strategy, government pricing, financial forecasting, and legal compliance, this role mitigates financial risks related to complex insurance rebates, chargebacks, duplicate discounts (e.g., 340B programs), and statutory government liabilities. The individual serves as a critical strategic partner to brand teams and managed markets account executives.

Key Responsibilities

1. Revenue Optimization & GTN Management

+ Monitor and analyze the gross-to-net (GTN) pipeline to identify revenue leakage points within commercial payer and government channels.

+ Partner with GTN forecasting to build accurate models for forecasting payer discount liabilities and pricing strategies.

+ Identify anomalies or unexpected financial variance in commercial and government rebates.

2. Contract Compliance & Fraud Prevention

+ Validate contract fulfillment terms against historical pharmacy claims data to identify overpayments or duplicate discounts.

+ Execute audit protocols for Pharmacy Benefit Manager (PBM) and payer rebate invoices.

+ Coordinate and support all aspects of such audit, including selection and coordination with third party auditors.

+ Responsible for the dispute process, including engaging with the customer, legal coordination, and escalation where required.

+ Oversee systems that flag and mitigate duplicate 340B drug discount violations paired with Medicaid rebates.

3. Government Pricing & Regulatory Oversight

+ Monitor calculation accuracy for federal pricing metrics including Average Manufacturer Price (AMP), Best Price (BP), and Average Sales Price (ASP).

+ Ensure absolute alignment with the Inflation Reduction Act (IRA), Medicaid Drug Rebate Program, and federal pricing structures.

+ Act as an internal control expert to protect the organization against federal compliance penalties.

4. Cross-Functional Strategic Collaboration

+ Partner closely with Account Management, Pricing Strategy, Legal, Finance, and Brand Management teams.

+ Ensure GTN financial impact of all disputes is appropriately captured

+ Support pre-deal analyses by assessing potential GTN and revenue integrity impacts.

+ Build executive-ready risk mitigation models outlining shifting regulatory or marketplace trends.

Job Requirements & Qualifications

+ Education : Bachelor's degree in Finance, Economics, Business Administration, or life sciences required. An MBA or advanced financial certification is highly preferred.

+ Experience : 5+ years of experience in the pharmaceutical or biotech industry, with a direct focus on Market Access, Pricing & Contracting, Gross-to-Net (GTN) accounting, or commercial financial analytics

Competencies

Accountability for Results - Stay focused on key strategic objectives, be accountable for high standards of performance, and take an active role in leading change.

Strategic Thinking & Problem Solving - Make decisions considering the long-term impact to customers, patients, employees, and the business.

Patient & Customer Centricity - Maintain an ongoing focus on the needs of our customers and/or key stakeholders.

Impactful Communication - Communicate with logic, clarity, and respect. Influence at all levels to achieve the best results for Otsuka.

Respectful Collaboration - Seek and value others' perspectives and strive for diverse partnerships to enhance work toward common goals.

Empowered Development - Play an active role in professional development as a business imperative.

Minimum $134,615.00 - Maximum $201,250.00, plus incentive opportunity: The range shown represents a typical pay range or starting pay for individuals who are hired in the role to perform in the United States. Other elements may be used to determine actual pay such as the candidate's job experience, specific skills, and comparison to internal incumbents currently in role. Typically, actual pay will be positioned within the established range, rather than at its minimum or maximum. This information is provided to applicants in accordance with states and local laws.

Application Deadline : This will be posted for a minimum of 5 business days.

Company benefits: Comprehensive medical, dental, vision, prescription drug coverage, company provided basic life, accidental death & dismemberment, short-term and long-term disability insurance, tuition reimbursement, student loan assistance, a generous 401(k) match, flexible time off, paid holidays, and paid leave programs as well as other company provided benefits.

Come discover more about Otsuka and our benefit offerings; https://ah-prod.com/multi/videoplayer/player.html?v=6385356920112 .

Join Our Talent Community: Stay connected with Otsuka by joining our Talent Community. Tell us about your interests, and we'll notify you about future opportunities that align with your background. https://community.hireez.com/cielo-otsuka/82cb3591

Disclaimer:

This job description is intended to describe the general nature and level of the work being performed by the people assigned to this position. It is not intended to include every job duty and responsibility specific to the position. Otsuka reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.

Otsuka is an equal opportunity employer. All qualified applicants are encouraged to apply and will be given consideration for employment without regard to race, color, sex, gender identity or gender expression, sexual orientation, age, disability, religion, national origin, veteran status, marital status, or any other legally protected characteristic.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation, if you are unable or limited in your ability to apply to this job opening as a result of your disability. You can request reasonable accommodations by contacting EEAccommodations@otsuka-us.com .

Statement Regarding Job Recruiting Fraud Scams

At Otsuka we take security and protection of your personal information very seriously. Please be aware individuals may approach you and falsely present themselves as our employees or representatives. They may use this false pretense to try to gain access to your personal information or acquire money from you by offering fictitious employment opportunities purportedly on our behalf.

Please understand, Otsuka will never ask for financial information of any kind or for payment of money during the job application process. We do not require any financial, credit card or bank account information and/or any payment of any kind to...

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Senior Manager, Contract Ops & Revenue Integrity (Remote)