Associate Director, Field Reimbursement - Upstate NY
- Develop cultivate business relationships within focused accounts. Assist oncology healthcare professionals and staff in resolving reimbursement issues/barriers in a manner that complies with DSI policies, processes and guidelines. Serve as a regional reimbursement expert by providing assistance to key oncology offices. The ADFR will work with all engaged sites of care to inform them on matters related to access and reimbursement of DSI's products. The ADFR may advise sites of care on payer specific nuances related to utilization managements protocols and appeals Partner with DSI oncology field staff to ensure aligned customer approach. Proactively communicate contract and formulary status relevant to each hospital and clinic account to drive appropriate product pull through.
- Educate customers on key Educate customers on product coverage, relevant patient journey dynamics, and key billing/reimbursement processes. Ensure strong understanding and utilization of Specialty Pharmacy and third party services. Conduct off-site meetings as needed with key office staff to learn about patient reimbursement challenges and educate them on DSI reimbursement support for company products. Extensive knowledge of regional and national payer landscapes with expertise in formulary decisions, reimbursement policy, utilization management criteria, prior authorization processes and appeal requirements. Develop ongoing interaction with clients in a manner that anticipates and adapts to customer reimbursement support needs as well as market changes/challenges.
- Build on existing relationships with key accounts, ADFR focused stakeholders (e.g. Revenue Cycle Managers, PA Team's, Billing Coordinators, Administrators), and prioritized third party organizations, Specialty Pharmacies, and hospital systems to develop and implement strategies which ensure patient access to DSI oncology therapies. Facilitates the development of long-term relationships between payers and DSI executive leadership to help identify areas of common interest for collaboration in furtherance of patient access. Understands specifics of support questions associated with patient reimbursement to coordinate on reimbursement issues and third party payers. Identify opportunities to complement DSI's capabilities to strengthen the ability for patients to gain access to DSI oncology products.
- Demonstrate extensive knowledge of specialty payer landscape, the appropriate utilization of NCCN/ASCO guidelines, private payer, GPOs, Medicare and Medicaid structure, Specialty Pharmacy systems and reimbursement processes and the general evolution of the healthcare landscape.
- Maintain a deep understanding of DSI policies/requirements and performs all responsibilities in a compliant/ethical manner. Handles PHI appropriately by ensuring compliance with HIPPA regulations, laws and internal company guidelines.
- Control business expenses related to field activities and maintains PL budget as assigned.
- Bachelor's Degree required
- Master's Degree or other advanced degree preferred
- 7 or More Years overall related experience, preferably within the pharmaceutical/biotech industry required
- Diverse experience with an awareness of oncology sales, sales management, training and/or marketing preferred
- Specialty Pharmacy, Reimbursement and/or HUB experience preferred and/or completed a developmental Market Access program such as the MADP (Market Access Development Program related to this position preferred
- Ability to travel up to 70% Must be able to travel to meetings and related Sales events.
- Must have a valid driver's license with a driving record that meets company requirements.
USD$168,400.00 - USD$252,600.00 Download Our Benefits Summary PDF
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