Develop and execute strategies for pricing prescription drugs and negotiating payer coverage to comply with the drug price reduction requirements outlined in the Inflation Reduction Act (IRA). Engage with professionals and industry executives, overseeing comprehensive pricing and contracting analyses to bolster the drug pricing and rebate framework. Collaborate with professionals and industry executives, spearheading comprehensive pricing and contracting analyses encompassing both quantitative a... more details
Drug Pricing Expert
Key Role:
Develop and execute strategies for pricing prescription drugs and negotiating payer coverage to comply with the drug price reduction requirements outlined in the Inflation Reduction Act (IRA). Engage with professionals and industry executives, overseeing comprehensive pricing and contracting analyses to bolster the drug pricing and rebate framework. Collaborate with professionals and industry executives, spearheading comprehensive pricing and contracting analyses encompassing both quantitative and qualitative aspects to bolster the drug pricing and rebate environment. Gather, examine, and incorporate cross-departmental data from diverse sources to assist in the process of scenario-planning and the generation of customer insights. Provide increased insight into the U.S healthcare market, the processes of Medicare Part B and Part D, the flow of data, and the processes involved in pharmacy reimbursement. Gather, examine, and verify Part D and Part B claims for negotiated medications and ascertain reimbursements and rebates associated with negotiated Maximum Fair Price (MFP). Collaborate with subject matter experts from various domains to develop a business architecture framework that is in line with the IRA drug pricing regulations and performance goals. Leverage broad expertise in driving enhancements for more effective management and tracking of claims and reimbursements throughout the entire payer and healthcare system. Consistently collaborate with top management to convert strategic plans into tangible results. Conduct targeted implementation of improvement opportunities to effectively oversee and monitor claims and reimbursements throughout the entire ecosystem by providing thought leadership. Consistently collaborate with top-level executives to convert strategy into implementation. Effectively convey outcomes promptly by employing structured management and performance evaluation. Due to the nature of work performed within this facility, U.S. citizenship is required.
Basic Qualifications:
5+ years of experience with work directly related to drug pricing patterns and their relationship to economic trends
Experience leading and implementing pharmacy programs, specifically Medicare Prescription Part B and Part D Drug Program
Experience with Medicare and the pharmaceutical drug supply chain
Experience with processing and validating claims from dispensers for selected drugs with an MFP, such as confirming the NDC or HCPCS for the selected drug, confirming the dispenser, checking for duplicates, checking for 340B status, checking for claims adjustments, and validation exercises
Knowledge of the relationships and interactions between drug manufacturers, wholesalers, plan administrators and plans, PBMs, pharmacies and dispensing entities, and beneficiaries
Ability to combine vision, creativity, and innovation to solve problems with strong business acumen, well-developed management, and leadership qualities
Ability to interpret policy and propose business solutions and initiatives related to the Inflation Reduction Act of 2022 and interpret the IRA requirements for implementation
Ability to develop and perform quality assurance and validation exercises related to Part B and Part D IRA drug pricing and rebates activities to encompass drug manufacturer, wholesaler, PBM, dispenser, TPA, and health plans ecosystem
Bachelor's degree
Additional Qualifications:
Experience with delivering technical assistance to a wide range of stakeholders and using a variety of delivery techniques
Experience in facilitating large meetings with both internal and external audiences
Experience with the federal procurement and proposal process
Ability to effectively communicate both verbally and in writing with customers, team members, and management
Ability to be a proactive self-starter and work independently and in a team environment
Ability to pay strict attention to detail
Possession of excellent communication and collaboration skills to work with various stakeholders, teams, sponsors, members, vendors, senior management, providers, and pharmacists
Possession of excellent analytical, problem-solving, and interpersonal skills
PMP Certification is a plus
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Salary at Booz Allen is determined by various factors, including but not limited to location, the individual’s particular combination of education, knowledge, skills, competencies, and experience, as well as contract-specific affordability and organizational requirements. The projected compensation range for this position is $96,600.00 to $220,000.00 (annualized USD). The estimate displayed represents the typical salary range for this position and is just one component of Booz Allen’s total compensation package for employees. This posting will close within 90 days from the Posting Date.
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