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Otsuka America Pharmaceutical Inc.
Director, Contract Operations & Revenue Integrity
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What they do
A Revenue Manager manages revenue flows for an organization. Prepares financial statements and business activity and forecasting reports; supervises accounting and preparation of financial reports; advises management with regard to finance decisions.
$163,497 / year median in the U.S.
+3% projected growth
Job Description
Remote Full time R12800 The
- Director, Contract Operations & Revenue Integrity
- oversees the financial execution, validation, and auditing of all commercial and government payer contracts.
- Key Responsibilities
- Rebate Validation & Payment Processing
- + •Oversee validation processes•for all commercial, Managed Care, PBM, and Medicare/Medicaid rebate claims.
- Authorize complex utilization data validation
- against contractual terms and formulary positioning. +
- Manage timely payment processing
- ensuring data accuracy and adherence to strict prompt-pay guidelines. +
- Maintain financial systems integrity
- by ensuring accurate mapping of contract rules within institutional software. +
- Ensure
- prompt and on-time payment with coordination with Finance and Treasury
- Revenue Integrity & Dispute Management
- + •Optimize revenue leakage•by identifying overpayments, duplicate claims, and systemic processing errors.
- Lead the dispute management framework
- to resolve payment variances and data discrepancies with payers. +
- Recover leakage funds
- through assertive, data-backed reconciliations and structured settlement negotiations. +
- Track financial recovery metrics
- to proactively address and mitigate future revenue erosion trends.
- Payer Auditing & Compliance
- + •Direct external audit programs•of payer customers to verify compliance with formulary exclusivity contracts.
- Manage internal and external compliance
- mandates, including SOX controls, government pricing audits, and corporate policies. +
- Standardize audit protocols
- and risk-assessment matrices to determine which payer accounts require immediate investigation. +
- Partner with Legal and Market Access Teams
- to enforce contractual remedies for non-compliant payer customers.
- Qualifications
- + •Bachelor's Degree required•in Finance, Accounting, Business, or Healthcare Administration.
- Advanced credentials preferred
- such as an
MBA, CPA, CIA
(Certified Internal Auditor), or MS in Finance. +- 8+ years of experience
- in pharma contract operations, gross-to-net analytics, or revenue compliance. +
- 4+ years of leadership
- experience managing validation analysts, auditors, or financial operations teams.
- Competencies
- Accountability for Results
- Stay focused on key strategic objectives, be accountable for high standards of performance, and take an active role in leading change.
- Strategic Thinking & Problem Solving
- Make decisions considering the long-term impact to customers, patients, employees, and the business.
- Patient & Customer Centricity
- Maintain an ongoing focus on the needs of our customers and/or key stakeholders.
- Impactful Communication
- Communicate with logic, clarity, and respect. Influence at all levels to achieve the best results for Otsuka.
- Respectful Collaboration
- Seek and value others' perspectives and strive for diverse partnerships to enhance work toward common goals.
- Empowered Development
- Play an active role in professional development as a business imperative. Minimum $186,489.00
- Maximum $278,875.
- Application Deadline
- : This will be posted for a minimum of 5 business days.
- Company benefits:
- Comprehensive medical, dental, vision, prescription drug coverage, company provided basic life, accidental death & dismemberment, short-term and long-term disability insurance, tuition reimbursement, student loan assistance, a generous 401(k) match, flexible time off, paid holidays, and paid leave programs as well as other company provided benefits.
Join Our Talent Community:
- Stay connected with Otsuka by joining our Talent Community.
https:
//community.hireez.com/cielo-otsuka/82cb3591Disclaimer:
- This job description is intended to describe the general nature and level of the work being performed by the people assigned to this position.
- Statement Regarding Job Recruiting Fraud Scams
- At Otsuka we take security and protection of your personal information very seriously.
- never
- ask for financial information of any kind or for payment of money during the job application process.
USD 14.2
billion in 2023. We invite you to explore our open positions for an opportunity to join our 2,200 colleagues in the U.S. whose passion for our mission and pride in our company have earned us certification as a Great Place to Work by the Great Place to Work Institute.Benefits
- Paid Time Off (PTO)
- Financial Aid/Assistance
- Professional Development
- 401(k) Plans