PRINCIPAL DUTIES AND RESPONSIBILITIES:
- Serve as a strategic partner to Contract Operations, Commercial FP&A, GTN, Managed Markets, Marketing, Finance, Legal, Regulatory, Procurement, and Commercial teams to ensure alignment on pricing strategy, data integrity, and system accuracy.
- Represent Government Pricing in cross-functional forums, including pricing committees and strategic initiatives.
- Provide government pricing impact assessments to support GTN modeling, forecasting, accruals, bid evaluations, and product launches.
- Develop and implement pricing strategies aligned with business objectives, regulatory requirements, and evolving market dynamics.
- Development of price strategies and scenario planning, compliance with various government price reporting requirements as well as Commercial contract requirements, and gross -to-net forecasting.
- Design and maintain complex financial pricing models to monitor performance against claims data and identify opportunities for cost savings, margin improvement, and contractual compliance.
- Apply advanced mathematical, statistical, and economic methodologies to analyze cost drivers and profitability across the pharmacy supply chain, recommending and implementing enhancements to pricing models.
- Evaluate and approve customer pricing requests, considering product strategy, market conditions, customer relationships, and financial impact.
- Lead pricing analysis for RFPs and bids, ensuring alignment with overall sales and profitability objectives.
- Identify pricing and contracting opportunities across customer segments to optimize financial performance.
- Support ongoing assessment of commercial agreements and their impact on government pricing.
- Lead communications with pricing service vendors and oversee the establishment of Payor Price list.
- Ensure compliance with government pricing regulations, including monitoring Care Enablement (CE) payer arrangements (e.g., GPO, distribution, specialty pharmacy fees).
- Provide guidance on healthcare policy, reimbursement trends, and regulatory changes impacting pricing and market access.
- Support rebate dispute resolution and manage agency-related communications as needed.
- Analyze commercial contracts to assess and model downstream government pricing implications.
- Support reimbursement strategy development, payor policy evaluation, and contract assessments.
- Ensure contracting practices and guidelines adhere to regulatory and compliance standards.
- Review reimbursement requests and evaluate contract terms for accuracy and alignment.
- Maintain and optimize pricing, contracting, and rebate systems to ensure accuracy, integrity, and compliance.
- Support chargeback processes, class-of-trade validations, and compliance monitoring activities.
- Develop and deliver dashboards, KPIs, and performance reporting to inform decision-making.
- Maintain documentation, ensure SOX compliance, and drive continuous process improvements.
Additional responsibilities may include a focus on one or more departments or locations.
See applicable addendum for department or location-specific functions.
PHYSICAL DEMANDS AND WORKING CONDITIONS:
- The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.
- Remote role
EDUCATION:
- Bachelor’s Degree required or equivalent work experience
EXPERIENCE AND REQUIRED SKILLS:
- 8+ years’ related experience.
- Understanding of US reimbursement across major payer segments
- High proficiency in MS Excel and experience with tools like SQL, SAS, Tableau, or BI software.
- Highly organized, able to meet deadlines, and work independently
- Strong communication skillset with keen attention to detail
- Strong analytical and problem-solving, ability to analyze large datasets to identify trends and financial opportunities.
- Ability to work both independently and in a team environment
- Self-starter who can be effective with minimal supervision
- Ability to grasp concepts and ideas quickly and thrive in a fast-paced environment
- Strong analytical, problem-solving, and data interpretation skills; proficiency in Access Database, experience SAP preferred
“The rate of pay for this position will depend on the successful candidate’s work location and qualifications, including relevant education, work experience, skills, and competencies. Base Rate: $165,000-$219,800
Benefit Overview: This position offers a comprehensive benefits package including medical, dental, and vision insurance, a 401(k) with company match, paid time off, parental leave and potential for performance-based bonuses depending on company and individual performance.”
Fresenius Medical Care is an equal opportunity employer and does not discriminate on the basis of race, color, religion, sexual orientation, gender identity, parental status, national origin, age, disability, military service, or other non-merit-based factors
