Senior Manager, Contract Ops, Revenue Integrity

This is a fully remote position, open to applicants in United States.

📋 Description

• Oversee and evaluate the gross-to-net (GTN) pipeline to detect revenue losses in both commercial payer and government sectors.

• Collaborate with GTN forecasting to create models for payer discount liabilities and pricing strategies.

• Detect anomalies or unforeseen variances in commercial and government rebates.

• Confirm contract fulfillment terms against pharmacy claims data to identify instances of overpayments or duplicate discounts.

• Implement audit protocols for Pharmacy Benefit Manager (PBM) and payer rebate invoices.

• Coordinate audits with external auditors.

• Handle disputes, including customer interactions, legal coordination, and escalation processes.

• Supervise systems addressing duplicate 340B drug discount violations in conjunction with Medicaid rebates.

• Track the accuracy of federal pricing metrics such as AMP, BP, and ASP.

• Ensure compliance with the Inflation Reduction Act (IRA), Medicaid Drug Rebate Program, and federal pricing regulations.

• Act as an internal control specialist to safeguard against federal compliance penalties.

• Collaborate with Account Management, Pricing Strategy, Legal, Finance, and Brand Management teams.

• Assess GTN financial impacts resulting from disputes.

• Assist in pre-deal analyses by evaluating GTN and revenue integrity impacts.

• Develop executive-ready risk mitigation models addressing regulatory and marketplace trends.

⛳️ Requirements

• A Bachelor’s degree in Finance, Economics, Business Administration, or life sciences is required.

• A minimum of 5 years of experience in the pharmaceutical or biotech sector.

• Direct experience in Market Access, Pricing & Contracting, Gross-to-Net (GTN) accounting, or commercial financial analytics.

• An MBA or advanced financial certification is highly preferred.

🏝️ Benefits

• Comprehensive medical, dental, vision, and prescription drug coverage.

• Company-sponsored basic life insurance.

• Accidental death and dismemberment insurance.

• Short-term and long-term disability insurance.

• Tuition reimbursement.

• Student loan assistance.

• Generous 401(k) matching.

• Flexible time off.

• Paid holidays.

• Paid leave programs.

• Additional company-provided benefits.