Commercial/Government Payer Leads (Gene Therapy) - Remote, PA | Biospace
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Commercial/Government Payer Leads (Gene Therapy)

Spark Therapeutics

Remote, PA
Posted Date:
Position Type:
Full time
Job Code:
Required Education:
Bachelors Degree
Areas of Expertise Desired:
Government Affairs,

Job Description

The Commercial/Government Payer Leads, Gene Therapy are responsible for an assigned mix of commercial or government payers which includes National and Regional Payers (Regional Independents, Regional Blues), Fee for Service State Medicaid (FFS Medicaid) and Medicare Administrative Carriers (MAC) Jurisdictions.  The Payer Leads, Gene Therapy lead all Spark Therapeutics execution of key business strategies in assigned commercial or government payers.  The objective of these business strategies is to advance access for patients with Rare Diseases who would benefit from Spark Therapeutics’ portfolio of Gene Therapy agents.  Incumbents must possess a strong balance of business acumen, interpersonal skills, practical, working knowledge of medical policy development and strong clinical aptitude (understanding of disease/disorders, burden on the patient and role gene therapy plays in treatment) in order to support execution of approved coverage and reimbursement strategies.   Commercial/ Government Payer Leads, Gene Therapy are also responsible for:
•   Serving as Spark’s single face to the commercial or government payer
•   Gaining access and appropriate reimbursement for Spark Therapeutics gene therapy agents
•   Solving coverage and reimbursement issues identified and triaged by the field teams for the assigned commercial/government payers (coverage and reimbursement issues include, but not limited to, Benefits Investigations, Prior Authorizations, non-coverage determinations and COE Payment)
•   Consistently reporting status and progress back to key stakeholders and is considered a key member of the approved Field Integration Teams which includes other members of the Commercial/Govt. team
In summary, the Commercial/Government Payer Lead, Gene Therapy lead all Spark Therapeutics activities in assigned commercial/government payers and is wholly accountable to meeting assigned business objectives for the commercial/government payer.


•   Required:  Minimum of 5 years of Commercial/Government payer experience with primary Commercial/Government payer account responsibility
•   Required:  5 years of experience with Medical Benefit products (Buy & Bill)
•   Required:  3 years of provider reimbursement experience in Pharmaceutical, Biotechnology industry or with a health plan
•   Required:  Medical benefit product launch experience in Commercial/Government payer role
•   Preferred:  Rare Disease experience
•   Preferred: Above required and preferred experiences requires Pharmaceutical, Biotechnology experience of at least 12 years
•   Bachelor’s degree in related field, MBA Preferred
•   Required:  Valid Driver’s License