Director of Market Access & Reimbursement

Proclinical is currently recruiting for a Director of Market Access and Reimbursement for a leading healthcare company located in Denver, CO. As the Market Access and Reimbursement Director, you will be responsible for creating and managing strategic and tactical elements of the US-specific reimbursement process to acquire coding, coverage, and payment for the company's products and services. The Director of Market Access and Reimbursement will work with the commercial organization to support sales and create payer-provider programs based on the value of the company's pathway.

Job Responsibilities:

• Design and execute strategies with professional organizations including societies, CMS, and AMA to secure coding for products.
• Developing and executing advocacy strategies with payers and policymakers to drive favorable customer adoption, coverage, coding and payment for the company's products currently marketed and in development.
• Work with senior leadership and other appropriate individuals from private and government payers and providers, in the US, to secure coverage and contracts.
• Develop relationships with payers post coverage to educate provider networks, design alternative payment models, and drive adoption of new technology.
• Provide strategic insight into product design, regulatory pathways and marketing strategies in partnership with new product innovation teams and allied functions.
• Addressing market access challenges across various settings of care and delivering key updates to internal and external customers on customer and market trends in a timely and consistent manner.
• Supporting high-level pull-through efforts in conjunction with the Associate Directors, Regional Market Access to drive coverage and adoption of new technology.
• Managing relationships with outside consultants and vendors providing prior-authorization and coding support, and managing engagement with the sales team to disseminate this information to customers and field/answer customer inquiries.
• Delivering presentations at medical society or payer forums as needed.

Skills and Requirements:

• BA/BS degree required; advanced degree highly preferred.
• 5+ years of experience working in the health care industry at a medical device or bio-pharmaceutical manufacturer, consultancy, trade association, or medical society
• In-depth knowledge of the US healthcare system including Medicare, Medicaid, and Private Payers.
• Prior experience developing and implementing a strategy for achieving Category 1 reimbursement in the U.S.
• Thorough understanding of market access considerations software services or other product which has led to a proven track record of contributing to growth through the creation of tactical and strategic market access plans and securing reimbursement status.
• Experience engaging with medical societies, Centers for Medicare and Medicaid Services (CMS), commercial health plans, and legislative stakeholders. Established relationships with public and private payers.
• External, customer-facing experience is required.
• Excellent communication skills, both oral and written.
• Prior people management experience is preferred.
• Foundational knowledge of health care coding (ICD-10, CPT, HCPCS).
• Previous experience working on, or with government relations teams.
• Demonstrated track record of being able to lead cross-functional initiatives effectively.
• Familiarity with assessing HEOR considerations for commercial success.
• Analytical, problem solving, persuasive ability to develop and implement strategic plans.
• Location preferred in Cleerly's office Denver CO. Alternate location is New York City or remote. Location is flexible as long as it is near major a airport with expectation that travel to those three sites and other as needed travel would be 25-50%.

If you are having difficulty in applying or if you have any questions, please contact Calvin Lee at (+1) 646-367-1089 or c.lee@proclinical.com.

Proclinical is a specialist employment agency and recruitment business, providing job opportunities within major pharmaceutical, biopharmaceutical, biotechnology and medical device companies.

Proclinical Staffing is an equal opportunity employer.

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