Director, Managed Care Rebate Operations

Summary
This role is accountable for strategic and functional leadership of a team responsible for accurate and timely Managed Care Commercial and Medicare Part D rebate processing and payments, data stewardship and compliance tied to financial reporting (GTN, projections and budgets), and evaluation/reporting of Managed Care data required for U.S. and Puerto Rico government pricing calculations.

Responsibilities
- Lead and develop a team responsible for systems and processes that collect, process, monitor and use Managed Care data for pricing calculations (e.g., rebate payments, GTN, projections, budgets, AMP, ASP, BP estimate, BP true-up, BP modeling of contingent/portfolio agreements, legal requests, SOX compliance, deal/contract performance analytics, and ad hoc analytics).
- Partner with other BMS functions to assess implications of rebate deal structures.
- Develop and maintain processes to estimate implications of contingent and portfolio rebate deal structures.
- Review and approve monthly and quarterly Managed Care processes supporting government pricing calculations; collaborate with Legal to monitor contracting/reporting requirements.
- Operationalize the BMS 340B strategy for Managed Care Rebate Operations and guide the team on the broader 340B landscape.
- Lead and collaborate with internal/external partners on PBM conflict/dispute resolution.
- Oversee external vendor contract negotiations, service levels, system enhancements, system controls, and issue resolution.
- Maintain departmental SOPs and ensure SOX compliance for rebate processing and appropriate categorization of Managed Care data for forecasting and government pricing.
- Coordinate with Treasury for Manufacturer Discount Program administration and payment responsibilities.
- Champion process improvement and process innovation; drive digital transformation/automation of pricing processes.
- Lead implementation and testing of Managed Care rebate systems (REACT$ and vendor interfaces).
- Lead/assist with special projects (e.g., IRA, Legal requests, dispute resolutions).

Qualifications
- Bachelor’s degree in an analytical, financial, or business-related program (or equivalent).
- Minimum 10 years of pharmaceutical/healthcare experience related to Managed Care.
- Experience with governmental pricing, bundled sales arrangements, SAP and GTN systems/methodologies (required).
- Strong technical/functional skills; able to motivate, develop, and lead as a player/coach.
- Strong interpersonal, communication, and consensus-building skills.
- Proven leadership experience supervising others.
- Strong analytical and strategic thinking about contracting approaches and government regulations.
- Strong healthcare marketplace understanding and business acumen.
- Demonstrated ability to drive execution, meet deadlines, prioritize in fast-paced environments, and perform data reporting/compliance with critical thinking.
- History of ethical and compliant behavior.
- Ability to coach and network across a matrix organization.
- Strong attention to detail; knowledge of controls and consistency with established processes.
- Proficiency with SOX controls, spreadsheet analysis, database management, and data delivery (required).
- Strong written and oral communication across all organizational levels.
- Demonstrated experience leveraging/implementing AI-driven insights and digital tools to improve engagement and drive data-informed decisions.
- Process automation experience (RPA, workflow automation, scripting) highly desirable.