Field Reimbursement Director - DMV (DE, MD, VA)

Company Name: Alnylam Pharmaceuticals

Overview

Reporting to the Field Reimbursement Director Team Lead, the Field Reimbursement Director will optimize access to Alnylam products in his/her region by understanding and addressing reimbursement and patient access challenges. This position requires a professional who can leverage his/her technical expertise and experience to deliver educational, reimbursement in-service programs to all sites of care (Medical Doctors Office, Alternative Infusion Centers, Hospital Outpatient Department, etc.) and manage access and reimbursement issues by initiating as well as leading action plans to resolve these issues.

A key component of this role is the ability to establish and deepen customer relationships through quality interactions with access and reimbursement focused external stakeholders at targeted strategic accounts. As such, extensive knowledge of ‘buy and bill’ products and prior experience with high-touch, high cost specialty products is essential.

The Field Reimbursement Team will be a critical component of the commercial strategy and work in close coordination with National Account Leads (NALs), Strategic Account Leads (SALs), Regional Account Leads (RALs), Patient Services and Sales to support Alnylam’s patient-focused vision of harnessing a revolution in biology for human health.

The successful candidate must be passionate about science and deeply motivated by the quest of delivering value to patients with the long-term success of the company in mind. He/she will work collaboratively with both internal and external stakeholders to build tactical plans to execute on the strategic imperatives.

Key Responsibilities

• Optimizes access to Alnylam products by ensuring that provider accounts understand access and reimbursement dynamics
• Proactively identifies trends impacting barriers to access or reimbursement and creates solutions
• Works with internal stakeholders and providers to support treatment pathways for patients
• Responsible for addressing and resolving outstanding claim payment issues
• Provides guidance to case managers on case-specific complex PA/Appeal issues
• Collaborates with case managers on treatment site finding for the specialty business when there are no site of care options available in the treatment directory
• Provides case-specific PA/Appeal support and site of care options for the rare business
• Maintains relationships with Medicare Administrative Contractors (MACs) to optimize coverage for Alnylam therapies and monitors Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs)
• Works with Public Policy & Government Relations team on engagement strategies and tactics regarding MACs or local policy changes as well as state-level public policy initiatives
• Utilizes reporting dashboards to track critical metrics and key performance indicators (KPIs)
• Ensures compliance with all corporate and industry policies in collaboration with Alnylam Legal, Regulatory and Compliance

Qualifications

• Bachelors degree required
• Minimum of 10+ years of experience within pharma/biotech industry; including minimum of 3+ years of patient access or relevant reimbursement experience
• Buy and bill experience preferred
• Rare disease experience preferred
• Established relationships with Medicare Administrative Contractors (MACs) highly preferred
• Strong knowledge of the US payer landscape
• Deep understanding of both medical benefit and pharmacy benefit across payer types (Medicare, Medicaid, commercial, VA/DoD, etc.) and sites of care (Hospital Outpatient Department, free standing centers and home infusion)
• Proven ability to identify key access and reimbursement barriers to treatment and design effective resolution plans
• Exceptional professional communication, interpersonal and problem-solving skills necessary to interact with decision makers (CFO and other C-suite level stakeholders)
• Demonstrated ability to lead without authority in a highly collaborative matrix and fast-paced environment
• Self-starter who is enthusiastic about rare disease and Alnylam’s core values: fiercely innovative, open culture, purposeful urgency, passion for excellence, and commitment to people
• Ability to travel up to 75%
• Must reside in Delaware, Maryland or Virginia

About Alnylam

We are the leader in RNAi therapeutics – a revolutionary approach with the potential to transform the lives of people with rare and common diseases. Built on Nobel Prize-winning science, Alnylam has delivered the breakthroughs that made RNAi therapeutics possible and are just at the beginning of what’s possible. Our deep pipeline, late-stage programs, and bold vision reflect our core values: fierce innovation, passion for excellence, purposeful urgency, open culture and commitment to people. We're proud to be a globally recognized top employer, where an authentic, inclusive culture and breakthrough thinking fuel one another.

Inclusion Statement

At Alnylam, we commit to an inclusive recruitment process and equal employment opportunity. Qualified applicants will receive consideration for employment without regard to their sex, gender or gender identity, sexual orientation, race, color, ethnicity, national origin, ancestry, citizenship, religion, creed, physical or mental disability, pregnancy status or related conditions, genetic information, veteran or military status, marital or familial status, political affiliation, age, or any other factor protected by federal, state, or local law. Alnylam is an E-Verify Employer.