Associate Director, Field Reimbursement

4 weeks ago

Seattle, United States Daiichi Sankyo, Inc. Full time

Join a Legacy of Innovation 110 Years and Counting

Daiichi Sankyo Group is dedicated to the creation and supply of innovative pharmaceutical therapies to improve standards of care and address diversified, unmet medical needs of people globally by leveraging our world-class science and technology. With more than 100 years of scientific expertise and a presence in more than 20 countries, Daiichi Sankyo and its 16,000 employees around the world draw upon a rich legacy of innovation and a robust pipeline of promising new medicines to help people. Under the Group’s 2025 Vision to become a “Global Pharma Innovator with Competitive Advantage in Oncology,” Daiichi Sankyo is primarily focused on providing novel therapies in oncology, as well as other research areas centered around rare diseases and immune disorders.

Summary:

The Associate Director, Field Reimbursement (ADFR) is a critical front-line member of the DSI oncology Field Reimbursement team. The primary purpose of this role is to serve as a field-based, product access specialist that provides appropriate reimbursement support to HCPs to help facilitate patient access to DSI oncology products. The ADFR (FRM) will provide reimbursement education and support to oncologists and professional staff, and to respond appropriately to HCP questions regarding the coverage landscape of DSI products. ADFR's provide strategic coverage/reimbursement leadership and support to internal DSI leadership and Care Team's to which their geographies align. This position will work with hospitals and clinics on how to appropriately improve patient access to DSI oncology medicines. The ADFR will provide in-person and telephone assistance to oncology HCPs to foster understanding and utilization of DSI and/or third party reimbursement support including but not limited to: benefits investigations, financial assistance options, and Specialty Pharmacy issues. They will also provide education on relevant health care changes, coverage impact of DSI oncology medications and formulary changes to ensure providers have known pathways to access DSI medicines. This position will also work with government, state and commercial payers to ensure the lines of communication remain open for existing and future DSI oncology products.

Responsibilities:

  • 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.

Qualifications:

Successful candidates will be able to meet the qualifications below with or without a reasonable accommodation.

Education Qualifications (from an accredited college or university)

  • Bachelor's Degree required

  • Master's Degree or other advanced degree preferred

Experience Qualification

  • 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.

Daiichi Sankyo, Inc. is an equal opportunity/affirmative action employer. Qualified applicants will receive consideration for employment without regard to sex, gender identity, sexual orientation, race, color, religion, national origin, disability, protected veteran status, age, or any other characteristic protected by law.

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