Senior Manager, MHC Strategic Policy and Payment Initiatives

Lake County, Illinois, USA
Feb 20, 2018
Required Education
Bachelors Degree
Position Type
Full time
The MHC Senior Manager, Strategic Policy and Payment Initiatives, is a high impact, in-house position that combines superior marketing and analytic capabilities to lead strategic initiatives and provide subject matter expertise on evolving government and policy payment changes that affect Abbvie and our customers across the healthcare landscape.
This position includes developing business impact analyses and leading strategic MHC initiatives to align Abbvie opportunities and mitigate risks arising from commercial payer and government policy and payment changes. The senior manager will develop, lead and support Policy and Reimbursement projects as a contributor to cross-functional teams, along with Government Affairs, HEOR, Medical Affairs and others; will implement Policy and Payment strategic initiatives in-house across Managed Healthcare, Integrated Brand Teams (IBTs) and Training and will implement in-field resources and initiatives for external stakeholders and customers as required.
The Senior Manager will develop, lead and train MHC field teams, such as MHC Health System Executives (HSEs) and Payer Executives - on evolving channel, policy and reimbursement requirements and access issues, including, but not limited to Medicare Part B and D programs, Medicaid, individual market/health exchange plan policies, ERISA and insurance law changes, MACRA Quality Payment Program (QPP) and value payment initiatives, including, but not limited to, developing Alternative Payment Models (APMs) such as ACOs, the Oncology Care Model, commercial bundled payment and other all-payer Alternative Payment Models. Success in managing internal and KAM team alignment and communications on evolving payment policies into brand strategies and communicating with senior leaders on projected business and LRP impact will be critical. Key Responsibilities Include:
  • Work with internal experts (Government Affairs, MHC Payer team, MABI) to develop an extensive network of external experts to develop and project the business impact of policy and payment changes on the Pharma industry and its stakeholders. Develop internal and external business and advocacy strategies to prepare for evolving policy and payment changes and ensure alignment through internal and external communication plans.
  • Develop and implement payer channel and policy marketing and advocacy initiatives and resources to support the franchise and pipeline portfolios.
  • Continuously monitor and provide in-depth subject matter expertise and guidance on channel and policy developments. Actively communicate key business impact/market dynamics to internal and external teams through the Policy and Legislative Impact Group, MHC and brand IBTs and other ongoing communication channels.
  • Nimbly translate channel and policy events into business considerations and priorities for strategic and tactical decision-making.
  • Consult with and lead policy and payment landscape training for internal and external MHC stakeholders, including, as needed, brand IBTs and account management teams.
  • Maintain relationships with stakeholder groups, including internal and external customers (payers, health systems, group practices, Centers for Medicare and Medicaid Services (CMS) consultants, medical specialty groups, advocacy and policy-maker organizations).
  • Advance initiatives to increase compliance with emerging quality, accreditation and healthcare transformation requirements for healthcare providers and payers.
  • Maintain continuous communication and strong collaborative relationship with cross-functional areas (Brand Teams, AbbVie Government Affairs, HEOR, Medical Affairs, etc.) to support IBTs and mutual business goals.
  • Maintain and participate in key advisory roles with multiple public policy, quality, provider, governmental and non-profit or advocacy organizations, including but not limited to AGA, NQF and NCQA.
  • Lead, develop and deliver AbbVie key account management (KAM) priorities on a range of channel and policy items, such as value-based payment and quality improvement.
  • Partner with MABI , HEOR, Medical Affairs, MHC brand and channel teams and others to determine Value for Real World (V4RW) and stakeholder value and evidence generation data needs. Lead and support Policy and Payment data analytics to inform deeper business and global development market needs and insights.
Qualifications: Basic:
  • Bachelor degree required
  • JD, MBA, MPH, PharmD or similar advanced degree strongly preferred
Professional Skills and Experience
  • Minimum 7-10 years of payer (CMS, Medicare Advantage or commercial), PBM, CMS consultants ), law or financial actuarial firm experience
  • Proven track record in strategic planning and operational implementation of initiatives to manage policy and reimbursement impact on portfolio such as 340B pricing, value-based engagements and therapeutic area-specific payment models, such as the Oncology Care Model (OCM)
  • Excellent writing , presentation and communication skills
Expected Competencies
  • Ability to develop and implement strategic vision
  • Effectively manage performance excellence through self-initiated performance assessment and growth plans. Work with manager to achieve highest level performance.
  • Infuse AbbVie Ways of Working and Talent Philosophy in day-to-day leadership and management of the business. Encompass “All for One AbbVie” mindset and perspective in all strategies.
  • Support the execution, tracking and monitoring of Marketing Plans by employing marketing skills included in the Mx2.0 framework. Demonstrate high proficiency in all aspects of the Marketing skills framework: Insights, Segmentation, Positioning, Value Proposition, Business Model Innovation, Creative Development and Investment Optimization.
  • Set tone and priorities for scale and scope of accountability. Demonstrate ability to influence multiple external and internal stakeholders and partners
  • Maintain highest standards of professional and personal integrity and conduct
  • Demonstrated competence in software tools, Power Point, Excel, Outlook, etc.
  • Ensure projects and travel expenses are managed within budget and submitted in required time frame.
Equal Opportunity Employer Minorities/Women/Veterans/Disabled