Prescription Drug Policy and Pricing Analyst

Overview: RTI International’s Center for Health Care Financing and Payment Research is seeking a researcher with expertise in prescription drug policy, drug pricing, clinical evidence, and health services research to support health policy projects and initiatives. The successful candidate will bring hands-on experience with federal prescription drug pricing programs, manufacturer statutory price calculations, drug coverage and reimbursement, , and will contribute to RTI’s growing portfolio of drug policy research and consulting for the Centers for Medicare and Medicaid Services (CMS) and other clients. Candidates may choose to work remotely within the United States or out of the Research Triangle Park, NC office. 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.

Qualifications: Minimum Qualifications:

• 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.).
• To qualify, applicants must be legally authorized to work in the United States and should not require, now or in the future, sponsorship for employment visa status (e.g., H-1B visa status, etc.).

Preferred Qualifications:

• Experience analyzing large healthcare data sets, especially Medicare or Medicaid claims and administrative data.
• Publication record in drug policy, drug pricing, clinical effectiveness, or health services research.

EEO & Pay Equity Statements: For San Francisco, CA USA Job Postings Only: Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records. Further information is available here. RTI accepts applications to our job openings from candidates with criminal histories or conviction records in accordance with all applicable laws, including the Los Angeles County Fair Chance Ordinance for Employers and the California Fair Chance Act. For Applicants in Massachusetts Only: It is unlawful in Massachusetts to require or administer a lie detector test as a condition of employment or continued employment. An employer who violates this law shall be subject to criminal penalties and civil liability. The anticipated pay range for this role is listed below. Our pay ranges represent national averages and may vary by location as a geographic differential may be applied to some locations within the United States. RTI considers multiple factors when making an offer including, for example: established salary range, internal budget, business needs, and education and years of work experience possessed by the applicant. Further, salary is merely one element to our offer. At RTI, we demonstrate our commitment to rewarding individual and team achievement through a total rewards package. This package includes (among other things) a competitive base salary, a generous paid time off policy, merit based annual increases, bonus opportunities and a robust recognition program. Other benefits include a 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, an employee assistance program, and numerous other offerings to support a healthy work-life balance. Hiring Salary Range: $142,000 - $176,000 Apply tot his job Apply To this Job