Field Reimbursement Director - Northern California
Alnylam Pharmaceuticals
20 days ago
On-site
United States
Market Access
Reporting to the Field Reimbursement Director, Lead, the Field Reimbursement Director will optimize access to Alnylam products in their region by understanding and addressing reimbursement and patient access challenges. Deliver educational and reimbursement in-service programs to all sites of care and manage access/reimbursement issues by initiating and leading action plans.
Key Responsibilities:
- Optimize access to the full Alnylam portfolio by ensuring provider accounts understand access and reimbursement dynamics
- Proactively identify trends impacting barriers to access or reimbursement and create solutions
- Work with internal stakeholders and providers to support patient treatment pathways
- Engage key account stakeholders (Intake/Authorization, billing compliance, Finance executives/Revenue Cycle and Revenue Integrity, infusion center management, pharmacy stakeholders)
- Identify, address, and resolve outstanding claim payment issues
- Provide guidance on complex PA/appeal issues
- Collaborate with case managers on treatment site finding when directory options are unavailable; provide case-specific PA/appeal support and site options
- Maintain relationships with Medicare Administrative Contractors (MACs); monitor LCDs and NCDs
- Work with Public Policy & Government Relations on MAC/local policy engagement and state-level initiatives
- Use reporting dashboards to track KPIs
- Ensure compliance with corporate/industry policies with Legal, Regulatory, and Compliance
Qualifications:
- Bachelor’s degree required
- 10+ years pharma/biotech experience
- 5+ years field reimbursement experience in “buy and bill,” preferably rare disease/oncology/specialty products and/or infusions/injectables
- Established MAC relationships (preferred)
- Strong US payer landscape knowledge
- Deep understanding of medical and pharmacy benefits across payer types and sites of care
- Proven ability to identify barriers and design resolution plans
- Exceptional communication/interpersonal/problem-solving skills
- Ability to lead without authority in a matrix environment
- Self-starter; motivated by rare disease and core values
- Travel up to 50%; reside near a mid-size/large airport
Benefits/Pay Range/Instructions:
- U.S. pay range: $195,500.00–$264,500.00; eligible for annual short-term and long-term incentives
- Comprehensive benefits include medical/dental/vision, life/disability, lifestyle reimbursement, flexible spending/HSAs, 401(k) with company match, paid time off, wellness days, holidays, and recharge breaks.
Key Responsibilities:
- Optimize access to the full Alnylam portfolio by ensuring provider accounts understand access and reimbursement dynamics
- Proactively identify trends impacting barriers to access or reimbursement and create solutions
- Work with internal stakeholders and providers to support patient treatment pathways
- Engage key account stakeholders (Intake/Authorization, billing compliance, Finance executives/Revenue Cycle and Revenue Integrity, infusion center management, pharmacy stakeholders)
- Identify, address, and resolve outstanding claim payment issues
- Provide guidance on complex PA/appeal issues
- Collaborate with case managers on treatment site finding when directory options are unavailable; provide case-specific PA/appeal support and site options
- Maintain relationships with Medicare Administrative Contractors (MACs); monitor LCDs and NCDs
- Work with Public Policy & Government Relations on MAC/local policy engagement and state-level initiatives
- Use reporting dashboards to track KPIs
- Ensure compliance with corporate/industry policies with Legal, Regulatory, and Compliance
Qualifications:
- Bachelor’s degree required
- 10+ years pharma/biotech experience
- 5+ years field reimbursement experience in “buy and bill,” preferably rare disease/oncology/specialty products and/or infusions/injectables
- Established MAC relationships (preferred)
- Strong US payer landscape knowledge
- Deep understanding of medical and pharmacy benefits across payer types and sites of care
- Proven ability to identify barriers and design resolution plans
- Exceptional communication/interpersonal/problem-solving skills
- Ability to lead without authority in a matrix environment
- Self-starter; motivated by rare disease and core values
- Travel up to 50%; reside near a mid-size/large airport
Benefits/Pay Range/Instructions:
- U.S. pay range: $195,500.00–$264,500.00; eligible for annual short-term and long-term incentives
- Comprehensive benefits include medical/dental/vision, life/disability, lifestyle reimbursement, flexible spending/HSAs, 401(k) with company match, paid time off, wellness days, holidays, and recharge breaks.