Director, U.S. Policy – Medicare Advantage Policy
About The Position
This position will work under the oversight of the Senior Director, Policy and Research and will be a Washington, DC or Princeton, NJ based role. The Director will lead policy development and strategy related to the Medicare Advantage market for BMS as a member of a highly collaborative and innovative team. This role requires deep expertise in policy, market, and access dynamics in the Medicare Advantage space and the ability to develop and advance solutions to protect patient access to medicines. The Director will lead internal cross-functional initiatives to develop and implement policy strategies to address reimbursement and access objectives in the Medicare Advantage market and must have proven ability to collaborate effectively with a range of internal business stakeholders. The Director will also serve as an external ambassador for BMS with trade associations, government agencies, and other key stakeholders to advance BMS’s policy objectives.
Requirements
- Advanced degree in Public Policy, Health Economics, Law, or related field.
- 10+ years of experience in health policy, government affairs, or reimbursement strategy, with a focus on Medicare Advantage and health plans.
- Direct experience with health plan coverage, formulary development, bid strategy, and access management decision-making in the Medicare Advantage space
- Strong understanding of the Medicare Advantage market, including CMS regulations, plan bid process, government funding, and market / vertical integration dynamics.
- Proven ability to lead complex projects, collaborate effectively with internal stakeholders, and influence policy outcomes.
- Exceptional written and verbal communication skills.
- Experience in biopharmaceutical or healthcare industry preferred.
- Familiarity with legislative processes and regulatory comment cycles.
- Ability to work in a fast-paced environment and manage competing priorities.
Responsibilities
- Develop proactive policy solutions to address emerging trends and risks in Medicare Advantage payment policy related to drug reimbursement, formulary management, and patient access (e.g., utilization management, step therapy).
- Monitor developments and assess impacts of Medicare Advantage program policies on risk adjustment, benefit design, network adequacy, prior authorization, quality measurement, and program integrity.
- Analyze federal legislation, rulemaking, guidance, and sub-regulatory actions to assess business, operational, and market impacts.
- Identify gaps and opportunities for policy innovation that align with organizational objectives and develop BMS positions for internal and external engagement.
- Identify and commission research to strengthen advocacy campaigns and inform policy positions.
- Translate complex data and evidence into compelling narratives for policymakers and stakeholders.
- Collaborate with internal teams to integrate research findings into advocacy strategies.
- Drive policy strategies to protect innovation, reimbursement, and patient access in the Medicare Advantage market.
- Collaborate with internal teams (legal, government affairs, market access) to align on advocacy objectives and effective engagement efforts.
- Lead cross-functional workgroups to develop proactive solutions for pricing, reimbursement, and access challenges in the Medicare Advantage market.
- Represent the organization in industry coalitions, trade associations, and stakeholder forums.
- Build and maintain relationships with policymakers, regulators, and advocacy groups.
- Prepare and deliver testimony, comments, and briefing materials for legislative and regulatory processes.
- Develop clear messaging on Medicare Advantage and drug pricing policy priorities for internal and external audiences.
- Provide training and updates to senior leadership and business units on market and policy changes in the Medicare Advantage space, including implications to BMS.
Benefits
- Medical, pharmacy, dental, and vision care.
- BMS Well-Being Account, BMS Living Life Better, and Employee Assistance Programs (EAP).
- 401(k) plan, short- and long-term disability, life insurance, accident insurance, supplemental health insurance, business travel protection, personal liability protection, identity theft benefit, legal support, and survivor support.
- Flexible time off (unlimited, with manager approval, 11 paid national holidays) for US Exempt Employees.
- 160 hours annual paid vacation for new hires with manager approval, 11 national holidays, and 3 optional holidays for Phoenix, AZ, Puerto Rico and Rayzebio Exempt, Non-Exempt, Hourly Employees.
- Unlimited paid sick time.
- Up to 2 paid volunteer days per year.
- Summer hours flexibility.
- Leaves of absence for medical, personal, parental, caregiver, bereavement, and military needs.
- Annual Global Shutdown between Christmas and New Years Day.
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What This Job Offers
Job Type
Full-time
Career Level
Director
