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Associate Director, Reimbursement & Health Policy

Company: Otsuka Pharmaceutical
Location: Princeton
Posted on: June 26, 2022

Job Description:

Reporting to the Senior Director of Reimbursement and Health Policy in Government Affairs and Advocacy (GAA), The Assoc. Dir., Reimbursement & Health Policy role is responsible for identifying, shaping, communicating and executing key aspects of the public policy agenda reflecting Otsuka's priorities and areas of leadership.-- The Associate Director position serves as one of the company's primary contacts to identify, analyze and develop the company's positions in conjunction with internal business units, state legislatures, Congress and parts of the Administration. This role interacts with many cross-functional teams, both externally and internally including trade associations of which Otsuka is a member company, consultants and other entities working with/for Otsuka, law firms, and advocacy/stakeholder groups. This role will be responsible for policy analysis of existing proposals at the federal and state levels. Additionally, the role will also be responsible for the development of ideas that support coverage, coding and reimbursement for Otsuka's current and future portfolio.Based in Washington, DC, the Associate Director, Reimbursement and Health Policy,-- interacts with various individuals and teams internally, including but not limited to business unit leaders across commercial and R&D, Legal, Compliance, Communications, Stakeholder Management, and external advocacy groups. This position will also partner with key advocacy and coalition partners to meet the needs of government payers, serves as a developer of key positions for coverage within Medicare/Medicaid, advances customer education, healthcare reform, health policy, and reimbursement.Key Responsibilities:

  • Monitors and analyzes proposed legislation and regulation to determine its effects on the industry; helps determine the most appropriate position for Otsuka; communicates those positions to federal and state teams as well as the relevant business units, trade associations and other external partners in coordination with Senior Director of Reimbursement and Health Policy and other senior staff; develops and implements strategies to achieve favorable results
  • Assists in the development of and executes on Otsuka's plans of action on federal and state policy for inline and future product portfolio
  • Collaborate with internal stakeholders on development of strategy and tactical planning
  • Develop and maintain a network of contacts across key agencies, trade associations and other relevant other key policy opinion leaders to ensure accounting of Otsuka's interests in important legislative environments
  • Helps raise profile of Otsuka within various coalitions and stakeholder communities, including advocacy, political, and trade associations
  • Responsible for the development of briefing materials, relative to the federal and state policy/legislative jurisdiction, for Otsuka's leadership and other senior executives for Congressional, Administrative, and trade association meetings/eventsEducation, Behavioral Competencies and Skills
    • Bachelor's degree required. JD, MBA or other Masters-level degree desirable
    • Minimum 7-10 years of pharmaceutical experience in a healthcare policy, reimbursement or payer experience (CMS, health plan, PBM), or related healthcare policy consulting, law or financial/actuarial firm experience
    • Thorough knowledge and understanding of healthcare reimbursement environment including coverage, HCPCS reimbursement coding application process, payment, as well as how to develop, implement and manage reimbursement strategies
    • Advanced knowledge of Medicare, Medicaid, Marketplace, VA, DoD, and Commercial programs and payer policies, reimbursement processes, and reimbursement coding inclusive of strategy development required. Knowledge of Government price calculations and compliance regulations preferred
    • Strong problem-solving skills, including the knowledge of source data with the ability to research complex policy issues with the ability to perform qualitative and lead quantitative analyses
    • Demonstrated experience working with federal healthcare programs, commercial payers/providers, and managed care organizations
    • Ability to work in a deadline-driven and fast-paced environment
    • Strong analytical and business skills; with the ability to communicate effectively across key internal and external teams
    • Demonstrated ability to process complex information and summarize it concisely in writing and/or verbally in a professional manner and in a time sensitive environment as requiredTravel Requirements
      • Willing to travel in the US up to 30%#LI-Remote

Keywords: Otsuka Pharmaceutical, Trenton , Associate Director, Reimbursement & Health Policy, Healthcare , Princeton, New Jersey

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