Director, Market Access - Strategy

Read on to find out what you will need to succeed in this position, including skills, qualifications, and experience.

Job Summary

This role is responsible for developing and delivering a strategic commercial market access vision & plan across reimbursement and access channels : Specialty Pharmacies, Home Infusion Services, GPOs, IDNs, PBMs, Commercial Health Plans, Medicaid and Medicare.

Essential Duties and Responsibilities

Include but not limited to the following. Other duties may be assigned.)

• Develop an access strategy for medical benefit therapies including site of care (SoC) and infusion chair expansion, training of nursing and address billing & coding elements.
• Build a SoC strategy to ensure expanded access to nursing, infusion chairs, home infusion (possibly through GPO contracting) and payor policy via coding crosswalk.
• Collaboratively evaluate current and anticipated SoC issues.
• Identify efficient infusion SoC to maintain and grow patient access.
• Develop contracting strategy to expand product access, secure nursing and add infusion capacity with potential; HOPD, infusion clinics, home infusion, and GPO opportunities.
• Build an access platform from which to launch incremental medical benefit-infused therapies with cold chain, and / or ultra-cold chain handling requirements.
• Build a network of pediatric neurology trained nursing capacity for cryogenic therapy.
• Develop office billing / coding tools, SoC value propositions and physician reimbursement education for high-priced Orphan infusible procedural-based therapies in the Duchenne Muscular Dystrophy (DMD) market in collaboration with Market Access Marketing.
• Demonstrate a deep understanding of health plans and the DMD patient journey of denials, prior authorizations, Medicare Parts A, B, C & D, as well as FFS & Managed Medicaid, VA, and DoD.
• Assist Market Access Marketing in creating communication tools designed to drive market access product and disease state education with channel customers and their specific stakeholder roles in alignment with corporate brand positioning and corporate strategy.
• Lead Market Access launch planning and develop with Market Access Marketing product launch communication tools and initiatives in collaboration with Market Access Training.
• Continue to partner with clinics, hospitals and home health to drive access to therapy while understanding effects on gross to net (GTN).
• Collaborate with NSP leadership team members while being the content expert of SoC, nursing, billing & coding and contracting (GPO, Clinics).
• Build and foster business relationships with market access Key Opinion Leaders, MA Associations (PCMA, AMCP, Asembia, EMPA, NHIA etc ) and State Societies.
• Collaborate with market access operations to communicate market access insights to various internal management, committees, and groups.
• Collaboration with the medical team on HEOR & Value Based Contracting strategies and coordinate payor insights with medical.
• Work extensively with, and understand the importance of, key internal constituents Market Research, Medical Affairs, Sales Analysis, Patient Services, Marketing and Operations etc.

as it pertains to market access opportunities to ensure efficiency and patient access.

Supervisory Responsibility

None

Qualifications

• Comprehensive experience in building launch strategies for high price, Orphan Drug, medical benefit, infusion, ultra-cold chain and procedure-based products.
• Experience with building strategies for payor coverage, coding and reimbursement processes and / or policy.
• Experience identifying and expanding site of care (SoC) strategies for current & future pipeline products.
• Ability to analyze and interpret regulations, legislation, rulemaking, policy advisory opinions and stay within legal guardrails.
• Provides timely response to customer requests per defined expectations.
• Demonstrated ability to create appropriate customer relationships built on trust in both clinical and non-clinical groups.
• Business acumen, analytical ability and negotiating skills with payers, IDN’s and GPO’s.
• Strong interpersonal, oral and written communication and presentation skills.
• Strong project management skills, ability to multi-task and prioritize with clear deliverables across multiple customers in tight timelines.
• Strong problem-solving skills, with good decisiveness, initiative and urgency for results balanced with exceptional people / organizational skills.
• Self-motivated, with the ability to work both independently and as a member of a cross-functional team.
• Demonstrated effective work results in a multi-cultural, cross-matrix, environment.

Education and / or Experience

• Minimum of bachelor’s in science or arts or the equivalent; MBA or advanced degree is preferred.
• Minimum of 10 years of pharmaceutical / bioscience or related experience with product launch experience - progressive market access experience in the pharmaceutical industry with 5 years in management-level positions with increasing responsibilities.

Market Access, Rare Disease experience is a plus.

Ability to travel and use team web meeting platforms to meet job description expectations.

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