Director, Reimbursement, Ophthalmology - West Region
The Director, Reimbursement Business Management will be responsible for hiring, managing and leading the reimbursement provider and payer support field teams for the West region. We are looking for a Director who will recruit, lead, mentor and manage the Regional Business Managers. These teams will ensure efficient provider and patient access, effective pull-through, reimbursement services and program support in collaboration with the Patient Support Services organization as it relates to the Regeneron Ophthalmology product portfolio. The West region includes 19 states.
A typical day may include the following:
• Collaborate with the Sales and Reimbursement leadership teams within Regeneron counterparts to lead Regional and local strategy for payer and provider access.
• Execute strategic & tactical field plan for all existing and new product reimbursement initiatives and relevant to defined needs in each respective customer market.
• Lead all field payer and reimbursement activity support by respective teams.
• Establish measurable performance parameters and monitor performance against these agreed parameters.
• Establish expectations for working closely with partners; Regeneron Regional Directors, respective Sales teams in assigned region as well as across the nation, Marketing, Access and Reimbursement Home office personnel at Regeneron, additional counterparts as defined, and National Accounts Managers to insure efficient coverage and knowledge of this coverage and services within the defined customer base.
• Assist in providing insight in the development of Market Access marketing support materials.
• Ensure reimbursement team has the required knowledge to ensure that Regeneron reimbursement personnel are seen as the most knowledgeable team in the industry as it pertains to reimbursement in the defined therapeutic area.
• Ensure that all teams are trained to fully support all reimbursement and patient/payer support programs offered by Regeneron and that customers view these programs as the outstanding.
• Develop and execute annual budget with allocation for all respective brand divisions. Insure group stays within financial budget.
To be considered for this opportunity:
We are seeking a strong collaborator, leader and mentor with at least 5 years' experience leading a field based account team, with at least 10 years' experience in the pharma/biotech industry. 5 years' experience within the Biologics, buy and bill market is required. You are the specialist for all areas of reimbursement including Account Management. We seek someone with detailed knowledge of CMS policies and processes with expertise in Part B & D (Medical/Pharmacy Benefit design and coverage policy) Familiarity with appropriate coding terminology and processes CPT, HCPCS, ICD-10, revenue codes and DRG, coverage and reimbursement. Must have familiarity with health insurance claim forms, explanation of benefits, and prior authorization forms. You will have the ability to function within an organization with evolving organizational structure, lead and influence cross functionally within various Regeneron departments. Travel within the US is required.
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Regeneron is an equal opportunity employer and all qualified applicants will receive consideration for employment without regard to race, color, religion or belief (or lack thereof), sex, nationality, national or ethnic origin, civil status, age, citizenship status, membership of the Traveler community, sexual orientation, disability, genetic information, familial status, marital or registered civil partnership status, pregnancy or maternity status, gender identity, gender reassignment, military or veteran status, or any other protected characteristic in accordance with applicable laws and regulations. We will ensure that individuals with disabilities are provided reasonable accommodations to participate in the job application process. Please contact us to discuss any accommodations you think you may need.