Alimera Sciences

  • Director, Reimbursement

    Job Locations US
    Posted Date 2 weeks ago(2 weeks ago)
    ID
    2018-1140
    # of Openings
    1
    Category
    Managed Markets
  • Overview

    The Director, Reimbursement will report to the Vice President, Managed Markets and will be responsible for leading and managing a team of Reimbursement Account Specialists and managing the operations of the ILUVIEN Reimbursement Hub as part of the Managed Markets team.  This person will work directly with the Payer Relations Directors and Sales Leadership, as well as the third-party vendor responsible for facilitating reimbursement services for ILUVIEN.  This position will focus on driving Alimera Sciences business objectives by overseeing all aspects of reimbursement, implementing reimbursement programs, providing input to strategic reimbursement plans and managing the field reimbursement team.  The Senior Director, Reimbursement will contribute new, creative, and innovative market access opportunities which are aligned with the brand strategic objectives, increasing adoption and pull through of ILUVIEN.  This individual will be responsible for developing, implementing and managing a best-in-class reimbursement support platform and patient access programs for ILUVIEN called AccessPlus. This person will also interact within a broader Market Access team, ensuring the full support of the implementation of the tactical plan developed by the market access leadership team. In addition, this position will provide critical competitive intelligence within the market access marketplace to executive leadership. The individual will provide updates, direction, and input to the Alimera Sciences leadership team and assist in the development of the overall market access strategic plan for ILUVIEN. The ultimate goal of the position is to maximize reimbursement confidence in ILUVIEN, to minimize ILUVIEN access barriers and promote/implement various programs and services to supplement the field sales force and management efforts.

    Responsibilities

    ESSENTIAL DUTIES AND RESPONSIBILITIES: 

     

    • The Director, Reimbursement will be responsible for 1) leading and managing a team of five Regional Reimbursement Managers and 2) managing the day-to-day operations of the AccessPlus Reimbursement Hub to budget and performance metrics.
    • Responsible for developing, implementing and launching the AccessPlus reimbursement support platform and patient access programs.
    • Develop and implement initiatives (programs, tools and materials) around reimbursement and patient assistance programs that align to the brand strategic objectives and proactively support external and internal stakeholders in the reimbursement process.
    • Plan, develop, execute and manage the communications (content and processes) of the reimbursement support platform and patient access programs.
    • Monitor the external environment and identify reimbursement trends (coding, coverage and payment) in support of the company and ILUVIEN.
    • Understand and analyze program data to effectively communicate information on a consistent basis to different functional areas in the commercial organization (Executive Leadership, Sales Leadership, Managed Markets and Marketing).
    • Provide direct management, guidance and professional development support to the Reimbursement Account Specialist team.
    • Collaborate with Marketing, Training, Legal, Regulatory, Sales Operations, Sales and Managed Markets to ensure optimal execution of patient access and reimbursement strategy.
    • Establish crucial relationships with a variety of stakeholders nationally: Practice Administrators, Practice Managers, Key Opinion Leaders, and Professional Organization/Society Leadership (RetNet, US Retina, etc).
    • Ensure the RAS team proactively identifies potential marketplace trends/barriers within respective geographies regarding ILUVIEN.
    • Ensure the RAS team reactively responds to any identified reimbursement, coverage issues and market access challenges within respective geographies for ILUVIEN.

     

    SUPERVISORY RESPONSIBILITIES

     

    • Reimbursement Account Specialists (5)
    • AccessPlus Reimbursement Hub Project Manager and Case Managers

    Qualifications

    QUALIFICATIONS 

     

    • Knowledge in managing various market segments including: product distribution and acquisition, reimbursement and coverage, patient access and financial assistance, health plans/federal marketplace, and physician networks.
    • Clear understanding of the implications of payer and reimbursement policy impact on prescriber and patient behaviors as well as sales force activity.
    • Strong knowledge and expertise in Medicare Part B, Medicare Advantage Plans, and Medicare Supplemental/Medigap Plans as well as Manufacturer and Foundation assistance programs.
    • Strong understanding and knowledge of reimbursement platforms and patient access programs supporting physician administered products.
    • Expert problem-solving skills with a demonstrated team orientation.
    • Demonstrated ability to manage multiple projects and excellent ability to prioritize work and meet deadlines.
    • Demonstrated exceptional leadership skills with internal and external stakeholders
    • Proven ability to deliver innovative achievements to support corporate objectives.
    • In-depth knowledge of managed care, state, federal and reimbursement sectors.
    • Ability to work, lead and influence cross-functionally within various departments.
    • Excellent verbal and written communication skills.
    • Superior organizational skills.
    • Ability to function as a self-starter with a high level of energy and drive for success.
    • Ability to rapidly assimilate information.
    • Ability to cultivate spheres of influence.
    • Strong interpersonal skills.

     

     

    EDUCATION & EXPERIENCE

     

    • Minimum of 10 years experience in the pharmaceutical/biotech industry
    • Minimum of 5 years managing teams with direct reports
    • Minimum 5 years experience in a practice facing, field based reimbursement role providing billing and coding education, coverage and policy guidance, follow up and issue resolution pertaining to the purchase, billing and reimbursement of a physician administered biologic
    • Previous experience managing a reimbursement hub/platform and patient assistance programs strongly preferred.
    • Medicare Part B and Commercial MCO account management experience with a physician administered biologic required.
    • Minimum 5 years of experience in any of the market access segments of the business: reimbursement, health plans, distribution, physician networks, federal marketplace
    • Multiple reimbursement-oriented launch experiences of a buy and bill physician administered biologic strongly preferred
    • Additional broad-based experience valued: sales with strong account management experience, sales operations, sales training, marketing, project management, Retina experience
    • Demonstrated ability to work in a fast paced, entrepreneurial environment strongly preferred

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