The opportunity
The primary role of the Sr. Director Pricing & Reimbursement is to oversee and determine strategic pricing and contracting strategies, and the tactical execution of those strategies to maximize the value of the Brand portfolio. This person must have in-depth knowledge of reimbursement, government pricing, and general pricing & contracting dynamics in order to best support the portfolio on WAC Pricing Recommendations for new products and in-line products and Reimbursement support. This role is also responsible for compliance and operational activities as it relates to WAC Pricing and Reimbursement. The Director Brand Pricing & Administration works closely with Market Access Strategy, Marketing, Government Pricing, Finance, Government Affairs, Patient Services, and Legal Affairs to implement all new product pricing and price increases.
Location: This is a hybrid role based in our Parsippany, NJ headquarters.
How you’ll spend your day
All areas of responsibility listed below are essential to the satisfactory performance of this position by any incumbents with reasonable accommodation if necessary. Any non-essential functions are assumed to be included in other related duties or assignments.
Assist in developing and implementing WAC pricing and contracting strategies, prepare pricing analytics to evaluate strategy alternatives, and implement those strategies that maximize the brand access and product value. Provide strategic guidance to the USBP Brand teams on pricing.
Represents Market Access on cross-functional teams relating to new product launches, product access initiatives, the financial impact of contracting, pricing activities and strategies, and evaluating the Gross-to-Net profile of business development opportunities.
Provides reimbursement expertise, defined broadly to include how products are covered and paid for by payers under pharmacy or medical benefit, for government (Medicare B, C, D, Medicaid) or commercial insurance, and patient’s OOP costs. This includes understanding payer coverage policy criteria, understanding government pricing (ASP, AMP, BP, 340B), and coding/payment dynamics across innovative brands, biosimilars, 505(b)(2), and generics.
Responsible for multiple compliance and operational activities related to Pricing and Reimbursement including but not limited to:
Pricing Committee
State pricing transparency submissions
HCPCS and Pass-Through Applications
Proposes WAC Price for new product launches and proposes WAC changes (increase or decrease) on existing products by continuously monitoring brand activity, competitive activity, and market conditions including but not limited to government pricing considerations.
In collaboration with Government Payer Systems and Government Affairs Teams, monitors changes and proposals in healthcare regulations and policies as it relates to Pricing and Reimbursement; and develops frameworks to evaluate the commercial implications to patients, providers, payers, and Teva brands.
Track and analyze WAC, coding and reimbursement status for Teva and competitors’ products, including WAC price changes, CMS updates to HCPCS codes, pass-through status, ASP, and SAD list. Take action if/when Teva products are incorrectly listed.
Collaborate with Payer Marketing and Patient Services to create tools, training, and resources regarding Pricing and Reimbursement, including but not limited to Coding and Reimbursement Guides.
Assess and recommend pricing packages for assets under business development evaluation
Hires, trains, supervises, develops and retains high performing staff.
