Director, U.S. Policy – Medicare Advantage Policy
Bristol Myers Squibb
5 days ago
Remote friendly (Washington, DC)
United States
Market Access
Position Summary
- Lead policy development and strategy for the Medicare Advantage market for BMS; oversee internal cross-functional initiatives to develop and implement policy strategies related to reimbursement and patient access; serve as an external ambassador with trade associations, government agencies, and stakeholders.
Key Responsibilities
- Develop proactive policy solutions addressing Medicare Advantage drug reimbursement, formulary management, and patient access (e.g., utilization management, step therapy).
- Monitor Medicare Advantage policy impacts on risk adjustment, benefit design, network adequacy, prior authorization, quality measurement, and program integrity.
- Analyze federal legislation, rulemaking, guidance, and sub-regulatory actions for business/operational/market impacts.
- Identify policy innovation opportunities aligned to organizational objectives; develop positions for internal/external engagement.
- Identify/commission research to support advocacy; translate evidence into narratives; integrate findings into advocacy strategies.
- Drive policy strategies protecting innovation, reimbursement, and patient access; collaborate with legal, government affairs, and market access; lead cross-functional workgroups.
- Represent BMS in industry coalitions and stakeholder forums; build relationships with policymakers/regulators; prepare testimony, comments, and briefing materials.
- Develop messaging and provide training/updates to senior leadership and business units.
Qualifications
- Advanced degree in Public Policy, Health Economics, Law, or related field.
- 10+ years in health policy, government affairs, or reimbursement strategy focused on Medicare Advantage/health plans.
- Experience with Medicare Advantage coverage, formulary development, bid strategy, and access management decision-making.
- Strong knowledge of Medicare Advantage (CMS regulations, bid process, government funding, market/vertical integration).
- Proven leadership in complex projects; strong collaboration and influence; exceptional written/verbal communication.
- Biopharmaceutical/healthcare industry experience preferred.
- Familiarity with legislative processes and regulatory comment cycles.
- Ability to work fast-paced with competing priorities; domestic travel up to 20%.
Benefits (explicitly listed)
- Health coverage (medical, pharmacy, dental, vision); wellbeing support (including EAP); financial protection (401(k), disability, life insurance, etc.); paid time off (flexible time off/annual vacation per location/role type).
- Lead policy development and strategy for the Medicare Advantage market for BMS; oversee internal cross-functional initiatives to develop and implement policy strategies related to reimbursement and patient access; serve as an external ambassador with trade associations, government agencies, and stakeholders.
Key Responsibilities
- Develop proactive policy solutions addressing Medicare Advantage drug reimbursement, formulary management, and patient access (e.g., utilization management, step therapy).
- Monitor Medicare Advantage policy impacts on risk adjustment, benefit design, network adequacy, prior authorization, quality measurement, and program integrity.
- Analyze federal legislation, rulemaking, guidance, and sub-regulatory actions for business/operational/market impacts.
- Identify policy innovation opportunities aligned to organizational objectives; develop positions for internal/external engagement.
- Identify/commission research to support advocacy; translate evidence into narratives; integrate findings into advocacy strategies.
- Drive policy strategies protecting innovation, reimbursement, and patient access; collaborate with legal, government affairs, and market access; lead cross-functional workgroups.
- Represent BMS in industry coalitions and stakeholder forums; build relationships with policymakers/regulators; prepare testimony, comments, and briefing materials.
- Develop messaging and provide training/updates to senior leadership and business units.
Qualifications
- Advanced degree in Public Policy, Health Economics, Law, or related field.
- 10+ years in health policy, government affairs, or reimbursement strategy focused on Medicare Advantage/health plans.
- Experience with Medicare Advantage coverage, formulary development, bid strategy, and access management decision-making.
- Strong knowledge of Medicare Advantage (CMS regulations, bid process, government funding, market/vertical integration).
- Proven leadership in complex projects; strong collaboration and influence; exceptional written/verbal communication.
- Biopharmaceutical/healthcare industry experience preferred.
- Familiarity with legislative processes and regulatory comment cycles.
- Ability to work fast-paced with competing priorities; domestic travel up to 20%.
Benefits (explicitly listed)
- Health coverage (medical, pharmacy, dental, vision); wellbeing support (including EAP); financial protection (401(k), disability, life insurance, etc.); paid time off (flexible time off/annual vacation per location/role type).