Director, Public Payer Strategy & Reimbursement Solutions
Location
Cambridge, MA | United States
Job description
Job Description
About This Role
The Director, Public Payer Strategy & Reimbursement Solutions serves as the US Market Access & Reimbursement lead for developing Biogen’s public payer strategy to ensure appropriate patient access and reimbursement, with a focus on Medicare and Medicaid. This individual will work cross-functionally with market access, brand teams, Finance, Medical, HEOR, global Value & Access, and Public Policy & Government Affairs (PPGA) to evaluate potential risks and develop innovative approaches for ensuring patient access to Biogen products.
This individual will support the entire Biogen portfolio (Alzheimer’s disease, MS, rare disease, neuropsychiatry, and pipeline) in the US Market Access & Reimbursement (MA&R) organization. This position reports to the Head of Pricing, Policy, & Contracts and can be based in Cambridge, MA or Washington DC.
What You’ll Do
Reimbursement Solutions
- Lead the development of innovative approaches to gain favorable Medicare Part B and D access for Biogen products
- Lead evaluation of reimbursement and regulatory policy changes affecting access to Biogen products including therapies for Alzheimer’s disease, MS, rare disease, and neuropsychiatry
- Lead CMS engagement on coverage and reimbursement topics as well as other market access-related policy issues, in collaboration with PPGA
- Support account management team in the development and execution of Medicare Administrative Contract (MAC) engagement strategy
- Support the development of Medicaid strategy to optimize access across Biogen portfolio, including targeting and prioritization of accounts in collaboration with regional account leadership team as well as internal alignment with brand and finance partners
- Support Neurology Account Specialist understanding of access barriers around coverage criteria for diagnostics, drug reimbursement, and reauthorizations across all payer segments
- Support access and reimbursement related field communications for Biogen and co-promoted products
- Serve as a liaison to PPGA in order to ensure alignment between Biogen’s market access and public policy objectives
Changing Healthcare System
- Monitor and evaluate the impact of state and federal policies that affect access to Biogen products, including in Medicare, Medicaid, and commercial channels
- Lead development of new market access strategies to support Biogen adaptation to state and federal policy changes.
- In collaboration with PPGA and Finance, evaluate potential impact and risks of proposed state and federal policies affecting access to Biogen products
- Support MA&R Account Directors and PPGA in engaging public payers (CMS, Medicaid, and Federal Accounts) to identify innovative access and reimbursement approaches, including but not limited to VBCs
- Conduct trainings to educate the US MA&R organization on public policy proposals
- Serve as a subject matter expert on Medicare and Medicaid policy
Who You Are
You are passionate about developing innovative solutions for expanding patient access. You enjoy working collaboratively with others in a fast-paced environment to identify actionable solutions that have an immediate impact on organizational objectives.
Qualifications
- Bachelor's degree required; MBA preferred
- 10+ years of relevant consulting, pharmaceutical, health care or regulatory experience
- Outstanding written and oral communication skills, including the ability to effectively deliver presentations to all levels of the organization
- Deep understanding of the US healthcare system, state & federal policy, and US market access & reimbursement trends
- Demonstrated experience in leading cross-functional teams in collaborative efforts to address patient access and/or reimbursement policy challenges
- Ability to think strategically and communicate recommendations to senior leadership
Preferred Skills
- Experience engaging US payers and/or policymakers
Additional Information
All your information will be kept confidential according to EEO guidelines.
Why Biogen?
Our mission to find therapies for neurological and rare diseases is a unique focus within our industry and this shared purpose is what connects us as a team. We work together to overcome obstacles and to follow the science. We are resilient as we strive to make an impact on our patients’ lives and on changing the course of medicine. Together, we pioneer. Together, we thrive.
At Biogen, we are committed to building on our culture of inclusion and belonging that reflects the communities where we operate and the patients we serve. We know that diverse backgrounds, cultures, and perspectives make us a stronger and more innovative company, and we are focused on building teams where every employee feels empowered and inspired. Read on to learn more about our DE&I efforts.
All qualified applicants will receive consideration for employment without regard to sex, gender identity or expression, sexual orientation, marital status, race, color, national origin, ancestry, ethnicity, religion, age, veteran status, disability, genetic information or any other basis protected by federal, state or local law. Biogen is an E-Verify Employer in the United States.
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