Director, Field Reimbursement West

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Role Summary

Director/Sr. Director, Field Reimbursement. Field-based leadership role responsible for developing and executing reimbursement and patient access strategies to ensure timely patient access to the company's products, building the infrastructure to support access, and partnering with internal and external teams including Patient Support Services, National Accounts, Sales, Trade, and Legal/Compliance. Requires strategic leadership, deep reimbursement expertise, and knowledge of healthcare regulations. Reports to the Head of US Field Reimbursement. Remote-West Coast; travel up to 50%.

Responsibilities

• Strategic Leadership: Develop and execute a comprehensive reimbursement and patient access strategy aligned with organizational objectives to ensure patients can access the company's products
• Team Leadership: Manage a team of Field Reimbursement Managers. Provide leadership, coaching, and support to ensure the team's maximum effectiveness
• Reimbursement Strategy: Oversee the development of FRM tools and execution of reimbursement strategies, which may involve working with pharmacies, health systems, and providers to secure patient access for appropriate patients
• Pharmacy Network Management: Support the evaluation, selection, and management of institutional pharmacies, ensuring optimal access for appropriate patients
• Compliance: Ensure that all reimbursement and patient access activities adhere to healthcare regulations and corporate compliance requirements, including relevant laws and industry standards
• Stakeholder Collaboration: Collaborate with internal/external partners, healthcare providers (prescribers and staff), the Hub, and pharmacies to facilitate patient access and address access challenges
• Data Analysis: Utilize data analysis and reporting tools to evaluate the efficiency and effectiveness of patient access processes, identifying areas for improvement and implementing necessary changes
• Policy and Market Analysis: Stay updated on changes in healthcare policy, market dynamics, and healthcare trends that may impact patient access
• Budget Management: Manage the budget for a team of Field Reimbursement Managers, ensuring cost-effective resource allocation
• Quality Assurance: Implement quality assurance measures to ensure each member adheres to the team’s standards and expectations

Qualifications

• Required: Bachelor's degree in a relevant field (Healthcare Administration, Business, etc). A master's degree or equivalent is a plus
• Required: 10+ years of field reimbursement and/or sales experience in the Pharmaceutical or Healthcare industries, including rare disease experience and launch experience
• Required: 5+ years of leading and developing high-performing teams (Sr. Director level)
• Required: Experience in Patient Services, Market Access, Reimbursement, or Patient Access Management
• Preferred: Experience working with Specialty Pharmacy Networks and Patient Services Hubs
• Required: In-depth knowledge of healthcare reimbursement processes and healthcare regulations
• Required: Exceptional leadership and team management skills
• Required: Strong knowledge of the payer environment, including government and commercial payers
• Required: Strong communication and interpersonal skills for collaboration with stakeholders
• Required: Proficiency in data analysis and reporting tools
• Preferred: Cardiology or experience in rare disease
• Preferred: Knowledge of HIPAA regulations, OIG guidance, Advertising and Promotion requirements, the Anti-Kickback Statute, and applicable policies, best practices, and guidelines
• Preferred: Commitment to patient-centered care and ensuring access to innovative treatments
• Travel: Up to 60% travel
• Other: Demonstrated curiosity and adaptability in adopting AI-powered tools and technologies

Education

• Bachelor's degree in a relevant field (Healthcare Administration, Business, etc). A master's degree or equivalent is a plus

Additional Requirements

• Remote-West Coast location
• Travel up to 60% (as noted above)