Senior Manager, Contract Ops & Revenue Integrity (Remote)

Key Responsibilities

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.

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.

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.

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.