Prescription Drug Policy and Pricing Analyst
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Job Description
Researcher specializing in prescription drug policy and pricing. Supporting health policy projects and initiatives at RTI International's Center for Health Care Financing and Payment Research.
Responsibilities:
- Provide deep subject-matter expertise on federal prescription drug pricing programs, including: Medicaid Drug Rebate Program (MDRP): AMP, Best Price, URA calculations, supplemental rebates, state rebate operations.
- 340B Drug Pricing Program: ceiling price methodology, covered entity eligibility, duplicate discount prevention, manufacturer and HRSA compliance requirements.
- Medicare Part B drug reimbursement policies, including ASP methodology (g., eligible transactions, role of discounts and chargebacks) and biosimilar reimbursement.
- Medicare Part D pricing and reimbursement, including pharmacy reimbursement, plan payments, and rebate dynamics.
- VA/FSS and other federal pricing requirements, including non-FAMP, federal ceiling price, etc.
- Interpret federal statutes, CMS and HRSA regulations, guidance, and rulemaking related to drug pricing, access, and reimbursement.
- Provide in-depth knowledge of commercial drug contracting, formulary strategy, and/or PBM operations.
- Support the design and interpretation of studies on drug utilization patterns and outcomes in populations and subpopulations, including Medicare and Medicaid.
- Provide subject matter expertise on the development of value frameworks, formulary recommendations, and drug coverage and reimbursement policies of public and private payers.
- Collaborate with multidisciplinary teams, including economists, physicians, statisticians, policy analysts, and programmers, to produce high-quality, policy-relevant deliverables.
- Translate findings into clear reports, briefs, presentations, and publications for diverse stakeholders.
Requirements:
- PhD and at least six years of relevant experience; or a Master’s degree and at least 10 years of relevant experience; or a Bachelor’s degree and at least 12 years of relevant experience.
- At least four years of experience in drug policy, government price reporting, health services research, healthcare consulting, managed care, or related work.
- Experience supporting federal contracting programs or working in a consulting environment.
- Experience with Medicare Part D and/or other prescription drug policies and programs, including Medicaid and 340B.
- Experience with domestic (United States) health policy.
- Familiarity with pharmacy claims, formulary design, quality measures (e.g., PQA, STAR ratings), and clinical drug evaluation.
- Ability to translate highly technical pricing concepts into clear, accessible explanations for federal audiences.
- Proven ability to collaborate across disciplines and manage multiple priorities in a fast-paced environment.
- Proficiency with Microsoft Office 365 Suite (Word, Excel, PowerPoint, etc.).
Benefits:
- competitive base salary
- generous paid time off policy
- merit based annual increases
- bonus opportunities
- robust recognition program
- competitive range of insurance plans (including health, dental, life, and short-term and long-term disability)
- access to a retirement savings program such as a 401(k) plan
- paid parental leave for all parents
- financial assistance with adoption expenses or infertility treatments
- financial reimbursement for education and developmental opportunities
- employee assistance program
- numerous other offerings to support a healthy work-life balance
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