Director, Contract Operations & Revenue Integrity

Otsuka Pharmaceutical Companies (U.S.); United States; On-site; USD 186,000 - 279,000; Full time

Benefits offered by this job

Comprehensive medical, dental, vision

401(k) match

Paid holidays and time off

Tuition reimbursement

Life insurance & disability coverages

Job summary

Otsuka Pharmaceutical Companies (U.S.) is seeking a Director to lead Contract Operations & Revenue Integrity. You will guide a specialized team validating rebate claims, managing payer disputes, processing payments, and conducting external audits to protect GTN revenue.

The role requires deep expertise in pharma contract operations, strong leadership, and a focus on compliance with internal policies and external regulations.

Qualifications

• Bachelor’s degree in Finance, Accounting, Business, or Healthcare Administration.
• Advanced credentials such as MBA, CPA, CIA, or MS in Finance preferred.
• 8+ years in pharma contract operations, GTN analytics, or revenue compliance.
• 4+ years leading validation analysts, auditors, or finance teams.

Responsibilities

• Oversee rebate validation and payment processing across payer contracts.
• Lead revenue integrity and dispute management to minimize leakage.
• Direct payer auditing and compliance programs, including SOX and pricing audits.
• Partner with Legal and Market Access to enforce contractual remedies.

Skills

Accountability for results

Strategic thinking

Problem solving

Cross-functional collaboration

Effective communication

Leadership

Team development

Education

Bachelor’s Degree in Finance/Accounting/Business/Healthcare Administration

MBA / CPA / CIA / MS in Finance

Job description

Director, Contract Operations & Revenue Integrity oversees the financial execution, validation, and auditing of all commercial and government payer contracts. This critical role ensures financial accuracy, eliminates revenue leakage, and maintains strict compliance with internal policies and external regulations. You will lead a specialized team responsible for validating billions of dollars in rebate claims, managing payer disputes, processing payments, and executing rigorous external audits of payer customers to protect the company's gross-to-net (GTN) revenue.

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 $278,875.00, plus incentive opportunity: The range shown represents a typical pay range or starting pay for individuals who are hired in the role to perform in the United States. Other elements may be used to determine actual pay such as the candidate’s job experience, specific skills, and comparison to internal incumbents currently in role. Typically, actual pay will be positioned within the established range, rather than at its minimum or maximum. This information is provided to applicants in accordance with states and local laws.

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.

Disclaimer

This job description is intended to describe the general nature and level of the work being performed by the people assigned to this position. It is not intended to include every job duty and responsibility specific to the position. Otsuka reserves the right to amend and change responsibilities to meet business and organizational needs as necessary.

Otsuka is an equal opportunity employer. All qualified applicants are encouraged to apply and will be given consideration for employment without regard to race, color, sex, gender identity or gender expression, sexual orientation, age, disability, religion, national origin, veteran status, marital status, or any other legally protected characteristic.

If you are a qualified individual with a disability or a disabled veteran, you may request a reasonable accommodation, if you are unable or limited in your ability to apply to this job opening as a result of your disability. You can request reasonable accommodations by contacting [e-mail].