In this newly created role, you will join RefleXion as it begins building out the Patient Access function. In line with our mission “to enable the first ever systemic reach for external-beam radiotherapy patients with any stage of cancer” you will be expected to anticipate, triage, and manage a variety of reimbursement issues that could impact patient access to our technology and execute all the necessary steps to support our commercial business in the United States.
RefleXion is the first and only external-beam radiotherapy company to utilize diagnostic radiopharmaceuticals to guide delivery of external-beam radiotherapy in real-time, thereby creating novel clinical and commercial opportunities. The company also plans to conduct rigorous clinical trials testing safety, effectiveness, and cost-effectiveness of its external-beam radiotherapy technology in conjunction with systemic drug therapies; as such, the policy manager will leverage their contacts, experience, and insights into the drivers of the payer reimbursement to create and find solutions that will demonstrate the value of the unique RefleXion technology to decision makers. The successful candidate will be a team player, strong lateral influencer, and motivator, develop coalitions and manage collaboration with influential external stakeholders. The ideal candidate for this role has experience in the pharmaceutical industry, possess an in-depth understanding of Medicare statutes and policies which govern cancer treatments in the hospital outpatient department and freestanding center setting (physician office), experience working with commercial payers, formularies, and other third-party entities and evaluation bodies which may have an impact on RefleXion’s reimbursement strategy.
- Closely monitor Medicare Administrative Contractors (MAC) and CMS activity to quickly identify proposed local and national coverage determinations, release and update of payment files, transmittals, and notices specific and relevant to payment, coding, and coverage of our technology
- Prepare and coordinate stakeholder comments on significant draft policies and guidelines issued by government agencies, specialty societies, technology assessment bodies and other influential organizations
- Work with customers, clinical and medical affairs, and radiotracer partners to develop clinical and cost-effectiveness models, compendia submissions, and other submissions to support reimbursement of procedures performed with the RefleXion technology, new tracers, and immunotherapies
- Work with hospital outpatient cost reporting departments to support the appropriate capture of charges to support stable payment under the Medicare prospective payment system
- Respond to customer coding, coverage, and payment inquiries and develop and update reimbursement guides
- Manage a reimbursement vendor responsible for supporting prior-authorizations and appeals and expansion of private payer policies
- Work freestanding centers to develop operational cost models and perform analyses to support adequate payment rates under Medicare
- Develop and cultivate internal and external stakeholder relationships including with KOLs, patient groups, specialty societies, industry organizations, hospital groups, etc.
- Facilitate and participate in meetings, including the preparation of meeting agendas, effective meeting management, and documenting meeting minutes with action items.
- Represent RefleXion in industry organization reimbursement workgroups
- Bachelor’s degree (or greater) with experience in public policy, business or health science preferred
- 10+ years of experience in the pharmaceutical industry (oncology a plus)
- Experience in a Market Access, Government Relations and/or Health Technology Assessment functions
- Excellent communication skills, both written and spoken
- Skilled at making sound decisions when faced with the time pressures and incomplete information.
- Skilled in critical thinking, problem solving and conflict resolution.
- Skilled in developing collaborative relationships and coalition building, with the ability to foster open communication with internal and external stakeholders.
- Demonstrated ability to manage influence through persuasion, negotiation, and consensus building with excellent oral and written communication skills.
- Must be highly organized with the ability to manage multiple projects/tasks simultaneously and effectively prioritize projects and tasks.
- Some domestic travel may be required up to 20%.
- Remote position
Company Benefits and Perks – What you will love about us!
All positions at RefleXion are eligible to receive the same benefits, listed here. We also want to highlight the following perks that add to our collaborative and team-work company culture. As we continue to grow as a company, we strive to have these benefits and perks grow with us – we are so excited for what is in store!
- The opportunity to work with a passionate, driven team in a pre-IPO start-up environment
- Competitive compensation and stock option package
- Medical (both HMO and PPO options), Dental and Vision
- Health Savings Account (HSA), Flexible Spending Account (FSA), Dependent Care Flexible Spending Account (DCFSA)
- Employee Assistance Program (EAP)
- 3 Weeks/Year PTO Accrual rate to start
- Employer paid Life Insurance
- RefleXion Benefit Hub – for company exclusive discounts and deals on a variety of sites and items
- Daily on-site lunches
- Kitchens filled with a variety of healthy and delicious snacks and drinks – including espresso and soda machines!
- Company culture building events such as Coffee Chats with the Executives, Friday Afternoon Ice Cream Socials and monthly Book Club
- On-site mobile car wash services weekly
- Electric car charging stations on site