Director – Policy & Research

PHRMA • Washington, DC

16h • Hybrid

About The Position

Pharmaceutical Research and Manufacturers of America (PhRMA) is seeking a Director for its Policy and Research team to support policy, as well as legislative and regulatory analysis, for Medicaid and the commercial health insurance market. The individual will be responsible for supporting PhRMA policy development and response to current and emerging public policy issues on coverage and access across the Medicaid and commercial health insurance markets, including state, insurer, and pharmacy benefit manager (PBM) actions.

The Director will:

Serve as a subject matter expert on public policy matters affecting Medicaid and the commercial health insurance markets with a focus on state, insurer, health plan, and PBM actions.
Provide expertise on federal and state policies affecting coverage and access under the Medicaid program, including program eligibility, the Medicaid Drug Rebate Program (MDRP), approaches to management of prescription medicines through Medicaid fee-for-service (FFS) and managed care, innovative contracting models, and other federal- and state-driven policies and waivers. 
Provide expertise on policies related to commercial coverage regulation and oversight, including in the Employee Retirement Income Security Act (ERISA) and the Affordable Care Act (ACA), as well as understand different aspects of regulation in these markets, such as health maintenance organizations (HMOs), flexible spending accounts (FSAs), and medical loss ratio (MLR).
Provide expertise on issues related to vertical integration of healthcare companies.
Understand insurer, PBM, and employer implemented copay adjustment programs such as accumulator adjustment programs, copay maximizer programs, and alternative funding programs (AFPs).
Analyze trends, research studies, and third-party policy analyses relating to Medicaid, employer-based coverage, and individual and small group insurance markets.
Analyze federal and state level legislation, regulations and other guidance related to the Medicaid program.
Analyze federal regulations and other guidance from the Departments of Health and Human Services, Labor, and the Treasury, and guide the development of PhRMA comment letters through established work group processes and engaging outside consultants as necessary and appropriate.
Lead the development of up-to-date talking points and materials in support of federal and state advocacy efforts on Medicaid and commercial health insurance coverage, including Medicaid managed care, individual and small group markets, employer-sponsored insurance, and Health Insurance Marketplaces. Analyze proposed legislation to identify key areas of interest for PhRMA members and coordinate with PhRMA’s Law department and others on potential amendments and legislative alternatives.
Prepare and deliver presentations on PhRMA’s priorities to groups external and internal to PhRMA and lead the development of slide decks, talking points, and other relevant materials.
Support PhRMA’s advocacy and third-party engagement with employer, insurance, and patient advocacy groups.
Identify gaps in existing research and analysis and recommend action to fill the gaps, working in concert with the Policy and Research team. Manage day-to-day interactions with external consultants on assigned department-initiated projects.
Perform other duties as assigned.

Requirements

• Bachelor’s Degree required.
• 6+ years of experience in legislative or regulatory policy and/or advocacy.
• Strong writing that communicates clearly and persuasively on advocacy issues.
• Strong verbal communication and presentation skills.
• Ability to synthesize, distill, and clearly communicate complex ideas to a non-technical audience.
• Be an adaptable, creative problem solver who is comfortable working in a high-pressure environment.
• Excellent interpersonal skills that foster the ability to design and manage multiple projects simultaneously.

Nice To Haves

• A Master’s degree in public policy or a related field.
• Prior experience working on Capitol Hill, or at HHS, a state legislative body, state regulatory agency, PBM, health insurance company, drug manufacturer, or health care trade association or consultancy.
• Experience developing and achieving public policy objectives in one or more of the following areas: Medicaid, ERISA, ACA, Health Insurance Marketplaces, or state-regulated individual and group health insurance.

Responsibilities

• Serve as a subject matter expert on public policy matters affecting Medicaid and the commercial health insurance markets with a focus on state, insurer, health plan, and PBM actions.
• Provide expertise on federal and state policies affecting coverage and access under the Medicaid program, including program eligibility, the Medicaid Drug Rebate Program (MDRP), approaches to management of prescription medicines through Medicaid fee-for-service (FFS) and managed care, innovative contracting models, and other federal- and state-driven policies and waivers.
• Provide expertise on policies related to commercial coverage regulation and oversight, including in the Employee Retirement Income Security Act (ERISA) and the Affordable Care Act (ACA), as well as understand different aspects of regulation in these markets, such as health maintenance organizations (HMOs), flexible spending accounts (FSAs), and medical loss ratio (MLR).
• Provide expertise on issues related to vertical integration of healthcare companies.
• Understand insurer, PBM, and employer implemented copay adjustment programs such as accumulator adjustment programs, copay maximizer programs, and alternative funding programs (AFPs).
• Analyze trends, research studies, and third-party policy analyses relating to Medicaid, employer-based coverage, and individual and small group insurance markets.
• Analyze federal and state level legislation, regulations and other guidance related to the Medicaid program.
• Analyze federal regulations and other guidance from the Departments of Health and Human Services, Labor, and the Treasury, and guide the development of PhRMA comment letters through established work group processes and engaging outside consultants as necessary and appropriate.
• Lead the development of up-to-date talking points and materials in support of federal and state advocacy efforts on Medicaid and commercial health insurance coverage, including Medicaid managed care, individual and small group markets, employer-sponsored insurance, and Health Insurance Marketplaces. Analyze proposed legislation to identify key areas of interest for PhRMA members and coordinate with PhRMA’s Law department and others on potential amendments and legislative alternatives.
• Prepare and deliver presentations on PhRMA’s priorities to groups external and internal to PhRMA and lead the development of slide decks, talking points, and other relevant materials.
• Support PhRMA’s advocacy and third-party engagement with employer, insurance, and patient advocacy groups.
• Identify gaps in existing research and analysis and recommend action to fill the gaps, working in concert with the Policy and Research team. Manage day-to-day interactions with external consultants on assigned department-initiated projects.
• Perform other duties as assigned.

Benefits

• In addition to a highly competitive salary and bonus program, various opportunities for reward and recognition and a platform of extensive benefits, PhRMA is committed to the development and overall wellbeing of our team members.
• We offer traditional (medical, dental, vision, flexible spending, life, AD&D, LTD, STD) and enhanced benefits such as parental leave, a well-being program, on-site fitness facility, back-up care, an employee assistance program, and pre-tax commuting benefits.
• We also offer a robust 401k plan with employer contributions upon the first day of hire and immediate vesting, a generous paid time off plan, -ten paid holidays (plus inauguration day), half day Fridays preceding holidays, half day Fridays in the summer months and a paid winter break.
• As an organization, we work together in the office on Mondays through Thursdays and remotely on Fridays. We also work remotely in August.
• We are committed to the growth and development of our team members and offer many learning opportunities including an integrated onboarding program, best-in-class leadership programming, tuition reimbursement, industry on-site and off-site training, and other management/professional development programs.
• Corporate social responsibility is also important to us at PhRMA. Our team members participate in community service activities, fundraising drives and charitable athletic events.
• We are committed to supporting our family of professionals at PhRMA and strive to create programs that help our team members manage the challenges of balancing a fast-paced career with their own personal goals.

What This Job Offers

• Job Type: Full-time
• Career Level: Director
• Number of Employees: 251-500 employees