Director/Sr. Director, National Reimbursement

Location
Seattle, WA, United States
Posted
Jul 26, 2021
Ref
1852
Hotbed
BioForest
Required Education
Bachelors Degree
Position Type
Full time

Director/Sr. Director, National Reimbursement

As the Director/Sr. Director, National Reimbursement, you will be responsible for the development and implementation of the overall site of care reimbursement and patient access strategy for the Omeros portfolio. Reporting to the Associate VP, Market Access, you will lead the field-based OMIDRIA Reimbursement Managers and the contract stem-cell transplant Reimbursement team. Working with cross-functional partners (i.e., Marketing, Sales, Advocacy, Account Management, Patient Services, and Medical), you will deploy solutions that drive local business opportunities, ensuring team alignment in overall execution of strategy. An expert in reimbursement and access (i.e. buy and bill processes, billing and coding, medical policy), you will be a key influencer to the overall market access strategy and payer value propositions across the portfolio.

Good things are happening at Omeros!

Come and be a part of our Reimbursement Team!

Who is Omeros?

True innovation requires the right people, and that's what we have at Omeros - smart, hard-working and creative individuals who collaborate and drive to achieve what has not yet been done. We see strength in diversity - diversity in thought, expertise and experience.

We have taken a similar approach in structuring our company. While many biotechs pursue a single therapeutic area or scientific platform, we are strategically building a deep and diverse pipeline of first-in-class small-molecule and antibody therapeutics. The strength of our scientific discoveries and exclusive intellectual property positions enable our pipeline programs to target highly promising receptors and enzymes that others have not been able to develop.

Although cutting across a wide and diverse range of disorders and therapeutic indications - some orphan, others large-market and many for which there are no approved treatments - all of our drugs on the market and in development target critical unmet needs to improve the lives of patients in meaningful ways.

Essential Duties & Responsibilities:

  • Attract, hire, and develop a diverse organization
  • Continuously coach and develop advanced leadership and patient access and reimbursement
  • Create a high-performance culture with emphasis on accountability, drive for/recognition of results, collaboration, ethical behavior, and a culture of accountability for conducting business with integrity within legal guidelines
  • Translate market insights to influence and/or shape reimbursement strategy
  • Partner with Market Access Leadership Team to provide input on payer value proposition and development of reimbursement acumen relative to the total account strategy; coach a team to effectively respond to payer marketplace changes
  • Implement a process for best practice sharing across the teams to maximize efforts in reimbursement
  • Lead and provide input into appropriate business strategies, plans, goals and tactics including expertise in reimbursement issues encompassing billing & reimbursement guidelines by payor and site of care, understanding guidelines, DRGs, and pricing structures
  • Support product launch teams with billing and coding needs, including vendor management when appropriate
  • Set measurable and consistent key performance indicators, holding team accountable and leading to achieve/exceed goals
  • Lead relationship with contract stem-cell transplant Reimbursement team vendor ensuring accountability with all SOPs, KPIs, compliance guidelines, and performance goals
  • Develop processes to drive clear communication with sales colleagues, ensuring clarity with reimbursement issues and trouble-shooting opportunities in support of pull through efforts
  • Ensure team operates consistently with Healthcare Compliance guidelines
  • Incorporate knowledge of dynamic and complex marketplace and business trends to deliver maximum access
  • Monitor National Commercial, Medicare, and Medicaid communications on coverage, coding, and payment policy and potential policy changes

Education, Experience, Skills, and Knowledge Required:

  • Bachelor's degree in business, marketing, or life sciences
  • 10+ years of biotechnology or pharmaceutical industry commercial experience including management experience
  • Experience with "start-up" bio pharma company and/or at least one product launch
  • Experience negotiating contracts and agreements
  • Experience and familiarity with ophthalmology, ultra-rare, rare specialty, or device products desirable
  • Experience and deep understanding of healthcare and account management, navigating complex accounts critical for success (working with health systems, IDNs, PEs etc.)
  • Exceptional business acumen and problem-solving skills; is aware of how different reimbursement strategies and tactics work in the marketplace
  • Advanced understanding of compliance and regulatory requirements
  • Demonstrated knowledge of payer decision-making, coverage, coding (i.e. J code), ASP, billing and patient access to specialty biologics, CMS, Medicare, Medicare Advantage, bundle vs. separate reimbursement, and pass through status
  • Demonstrated ability to recognize and interpret business issues/opportunities and make sound business judgments regarding solutions
  • Outstanding collaboration and networking capabilities
  • Demonstrated success leading teams through collaboration with other members within and across sales, marketing, market access, medical, and other groups to improve overall effectiveness
  • Good interpersonal and communication skills (both verbal and written), planning and organizational skills
  • Proficient with MS Office and basic technology tools

Behavioral Competencies Required:

  • Ability to build strategic relationships and problem solve with key internal and external customers
  • Ability to influence and negotiate with business partners, management and senior level leaders regarding matters of significance to the organization
  • Strong team player with demonstrated ability to build and maintain positive relationships with management, peers, and subordinates
  • Adept at creating and communicating a clear vision among cross-functional team members effectively aligning resources to achieve functional area goals
  • Ability to make decisions that balance a variety of factors to achieve optimal outcomes
  • Strong project ownership and sense of urgency to deliver best results on time
  • Proven track record of consistently meeting or exceeding results and/or other quantitative targets, as well as qualitative goals
  • Demonstrates confidence
  • Integrity and personal credibility

Other Requirements:

  • Ability to travel up to 50% of the time

If you have the experience, skills and knowledge we are seeking, we'd love to hear from you! This is an exciting opportunity for the right person!

Omeros is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to status as a protected veteran or a qualified individual with a disability, or other protected status such as race, religion, color, national origin, sex, age, marital status, or any other factor determined to be unlawful by federal, state, or local statutes.

It is our policy to provide reasonable accommodation to anyone with a disability who needs assistance completing the job application process. If you need assistance, you can either send an e-mail to hr@omeros.com or contact Omeros, asking for Human Resources, at (206) 676-5000.