Regional Business Director, Field Reimbursement - Gulf Coast

Sun Pharmaceutical Industries Ltd

4d•$185,000 - $225,000•Onsite

About The Position

The Regional Business Director of Field Reimbursement is a field-based leadership role supporting the market access strategy for the Sun family of products across the branded business units. This role provides leadership related to health policy, reimbursement, patient access and coverage within an assigned geography, managing a team of approximately 7 Field Reimbursement Managers. The person in this role will lead their team of Reimbursement managers supporting primarily the Biologic Dermatology Business Unit, the Specialty Dermatology Business Unit, and the Oncology Business Unit. In this role, this individual will serve as a field subject matter expert on access and reimbursement, coding, coverage, payer processes, and payer policies. This individual will have a deep knowledge of the U.S. payer landscape and understand the changes associated with Health Care Reform as it relates to patient coverage. As an expert in patient access and coverage, the Region Business Director will be expected to have extensive knowledge of local, regional, and national payer policies. Their expertise needs to include a strong understanding of government and commercial payers, the buy and bill process, working with alternate sites of care, appeals and exceptions processes, CMS coverage determination updates, HUB support, and field operations. This individual will need to have a strong ability to manage complexity and work in a dynamic, fast-paced business environment. Finally, this individual will be the technical expert coaching their team members on appropriate coding guidelines, CPT, J-code, and Diagnosis code utilization while elevating their understanding of the market access landscape. The Region Business Director will be critical in the process to identify, triage, and elevate reimbursement issues to the appropriate internal and external stakeholders.

Requirements

A minimum of a Bachelor’s Degree is required.
Prior experience with field reimbursement of launch products, biologics and buy and bill products is required.
A minimum of 2-3 years of field leadership along with reimbursement related experience is required.
Extensive knowledge of coding, billing, and the Market Access landscape is essential.
Demonstrated team leadership and strong cross functional collaboration is a must.
Experience working with both Community and Hospital based practices is required.
Candidates should have an advanced understanding of the federal regulatory processes and healthcare policy development especially the Medicare/Medicaid program.
This position requires up to 50% travel.

Nice To Haves

A Master’s Degree is preferred but not required.
Previous Market Access experience is a plus.
Previous Immunology, Dermatology and Oncology experience is a plus.
Direct experience working with the Centers for Medicare & Medicaid Services (CMS) or other key government agencies is a plus.
Prior experience and knowledge of the complexities of pull through for biologics, oncolytics, injectable, infusible, and oral therapies is preferred.

Responsibilities

Effective management and coaching of a field team to execute against access performance metrics for the individual brand teams.
Incorporate knowledge of dynamic and complex marketplace and business trends to deliver maximum access to the portfolio of Sun products.
Lead their teams in the build of approved/ compliant local strategies supporting access and coverage of their product portfolio.
Routinely review national policies and legislation information, identifying important reimbursement issues for input into brand strategies.
Monitor national Commercial, Medicare and Medicaid communications on coverage, coding and payment policy and potential policy changes.
Develop and maintain a relevant network of decision makers and opinion leaders in the field of reimbursement policy.
Strong collaboration and coalition building with industry stakeholders (e.g.; trade associations, advocacy groups, regulatory authorities).
Anticipate changing payer landscape by demonstrating a deep understanding and knowledge of public payer emerging trends that can impact access for Sun’s branded products and pipeline.
Translate policy developments into meaningful guidance and strategic advice.
Significant experience and understanding an ever changing payer environment and its impact on access of products administered in a healthcare setting.
Prioritize team efforts across stakeholders to maximize opportunities, share customer insights and aid the team in obtaining and allocating resources.
Lead the reimbursement specialist team in developing and executing Account Plans in cooperation with relevant functions (Sales, Marketing and Pricing).
Work closely with the Corporate Account Directors supporting access and coverage needs of key accounts.
Provide inspirational leadership to the reimbursement specialists’ field team.
Hold team accountable for results and reinforce appropriate customer focused behaviors.
Effectively communicate key legislative and health policy updates to the field sales organization and key external stakeholders.