Manager of Government Reporting and Pricing

Mayne Pharma

20h

About The Position

The Senior Manager of Government Reporting and Pricing is responsible for ensuring full compliance with U.S. federal and state government pricing and rebate programs, including Medicaid, Medicare, VA/DoD, PHS/340B and State Pricing Transparency initiatives. This role serves as a subject matter expert on government pricing regulations and methodologies, oversees pricing submissions and rebate operations, partners cross functionally to support pricing strategy and GTN modeling and leads continuous improvement initiatives to enhance accuracy, controls and automation and compliance in a dynamic regulatory environment.

Requirements

Deep expertise in U.S. government pricing regulations and compliance framework
Strong analytical skills with ability to investigate and explain pricing variances
Proven ability to manage complex and high-risk compliance processes
Cross-functional leadership and stakeholder management
Strategic thinking with strong execution and attention to detail
Experience managing vendors and external pricing platforms
Ability to operate effectively in a fast-changing regulatory environment
Bachelor’s degree in finance, Accounting, Business, Economics or a related field.
6+ years of experience in pharmaceutical or biotechnology government pricing, reporting or compliance
Extensive experience in Medicaid, Medicare, VA/DoD and 340B pricing programs
Strong understanding of GTN, contract analytics and rebate financial flows
Advanced proficiency with pricing systems, data analytics tools and financial reconciliations

Responsibilities

Government Pricing and Reporting – Lead the development, submission and ongoing maintenance of quarterly government pricing calculations and reports (AMP, ASP, BP, FCP, NFAMP, PHS/340B, etc..) in partnership with Integrichain.
Ensure timely, accurate reporting to CMS, HRSA, VA/DoD and State Medicaid Agencies.
Manage and maintain comprehensive compliance documentation, including SOPs, reasonable assumptions, calculation methodologies and audit-ready support.
Medicaid & Rebate Operations – Ensure accurate and timely payment of all Medicaid and non-Medicaid rebate obligations.
Evaluate and apply validation guidelines in alignment with evolving regulatory requirements.
Aggressively manage and resolve disputed rebate claims; develop and refine state-specific dispute resolution strategies.
Continually assess the effectiveness of Integrichain Medicaid processing and identify opportunities for improvement.
Compliance, Controls & Audit Support: Ensure full compliance with federal and state pricing regulations.
Perform key compliance processes including GL reconciliations, Class of Trade (COT) review, Bona Fide Service Fee (BFSF) evaluations and PHS/340B Eligibility reviews.
Monitor customer violations, BFSF treatment, and customer COT assignments.
Support audits, government inquiries and litigation responses while maintaining a strong internal controls environment.
Policy, Strategy and Impact Assessment: Monitor and evaluate proposed and enacted government pricing policies (MFN and other drug pricing reforms) and assess potential financial and operational impacts.
Provide government pricing impact assessments for GTN modeling, forecasting, accruals, bid evaluations and product launches.
Represent government pricing in pricing committees and cross-functional strategic initiatives.
Process Improvement and Innovation: Drive enhancements to pricing methodologies, automation tools, dashboards, and executive reporting.
Identify and lead process improvement initiatives and support special projects as assignment.
Continually assess alternative data and validation sources to strengthen claims processing and dispute resolution.
Industry & Regulatory Expertise: Stay current on industry trends, regulatory changes, and policy developments; proactively evaluate their impact on compliance and pricing strategy.
Serve as a subject matter expert on government pricing regulations, methodologies, and best practices.
Apply Fair Market Value methodologies in evaluating Bona Fide Service Fees paid to Wholesalers, PBMs and GPOs.