Associate Principal, Medicare Part D Policy

Avalere Health is seeking an Associate Principal with extensive expertise in Medicare Part D policy, coverage, and payment to join our policy practice.

Avalere Health is a vibrant community of innovative thinkers dedicated to solving the challenges of the healthcare industry. We dig deep into the healthcare system and work closely with clients to develop practical solutions. At Avalere Health, we prize curiosity, resilience, a positive attitude, and an enthusiasm to embrace new challenges. Join us and get ready to make your mark on healthcare!

 Avalere’s policy practice focuses on a range of issues, including federal and state health reform, drug pricing, Medicare policy and payment, Medicaid and other state health policies, Medicare Advantage, evolving benefit designs in public and private payers, etc.

We rely on deep subject matter expertise and understanding of the business issues facing our clients to assess how this changing policy landscape impacts the pharmaceutical industry, managed care plans, providers, and consumers. We provide analytic support and advisory services, including legislative strategy, regulatory analysis, and quantitative modeling of proposed and enacted policies to a wide range of clients across the healthcare industry.

The Associate Principal, Medicare Part D Policy, will support client engagements that inform business and advocacy strategy related to the impact of Part D program policy on access to care, the relationship between the Centers for Medicare & Medicaid Services (CMS) and plan sponsors in administering the program, the financial incentives that underpin stakeholder decision-making, and contracting arrangements between plan sponsors and drug manufacturers to support formulary development.

The ideal candidate would have deep knowledge of the Medicare Part D program, especially related to how the benefit works today from a financial and programmatic perspective. They will also have a good grasp of the various Part D provisions within the Inflation Reduction Act (IRA), and the primary Part D policy issues evaluated by MedPAC and other stakeholders related to the sustainability of the program over time.

Responsibilities

  • Serve as a key subject matter expert on Medicare Part D policy-related issues impacting the pharmaceutical industry, plan sponsors, the federal government, and other stakeholders
  • Work with teams within the policy practice and across the firm to solve complex client problems and engage clients with novel solutions and ideas
  • Create both strategic and tactical recommendations for clients depending on their policy and business needs
  • Help generate business with new clients and grow business with existing clients
  • Manage a portfolio of clients to identify and deliver on business opportunities and projects that dovetail with Avalere’s expertise and offerings, particularly around Medicare Part D and drug pricing
  • Manage multiple clients and short- and long-term deliverables to ensure that Avalere’s knowledge and expertise are available to meet client needs
  • Solve complex client issues in a timely and appropriate manner with minimal management oversight and attention to resources
  • Conceptualize, design, and execute—from start to finish—a broad range of client projects involving diverse, cross-functional, cross-practice teams
  • Train, supervise, and mentor staff members within the practice and across the firm

Skills, Experience, and Other Job-Related Requirements

Education Requirements

  • A graduate degree in health policy, public policy, healthcare management, public health, public administration, health economics, business administration or a relevant discipline. A combination of bachelor’s degree and in-depth relevant work experience is also acceptable.

Skill Requirements

  • Understanding of the Part D benefit structure, including historical and current program trends related to premiums, manufacturer rebates, formulary development, and federal payment flows
  • Significant experience analyzing policy proposals, legislation, and regulations and conveying findings to clients and the public
  • Sophisticated understanding of the policy issues impacting the healthcare sector, business dynamics in the marketplace, and how federal policy impacts industry
  • Experience overseeing and directing the work of staff members
  • Proven situational leadership skills and the ability to motivate and generate enthusiasm with individuals across all levels of the organization
  • Exemplary interpersonal skills that translate into positive relationships with colleagues and clients
  • Commitment to working in a team environment with an emphasis on collaboration and maintaining positive relationships with colleagues and clients
  • Solid communication skills (written and verbal) including the ability to concisely explain complicated concepts to executives within and outside of the firm
  • High level of initiative coupled with quick learning ability.

Experience Requirements

  • 5–10 years of relevant work experience, which could include employment by a pharmaceutical or health insurance company, relevant trade group, or advocacy organization
  • Experience in the government, the financial services industry, or a professional services firm thinking critically about or working on behalf of the healthcare industry is an appropriate substitute for direct industry experience
  • Experience should be focused on Medicare Part D and related policy issues
  • Experience overseeing and directing the work of staff members

Avalere is an Equal Opportunity / Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected veteran status.

Consistent with our safety protocols, the company will require a vaccination attestation for fully office-based and hybrid (office/remote) positions. Positions designated as fully remote are exempt from the attestation requirement unless and until such time as an in-office presence is required.