Field Reimbursement Director - South Florida

Overview:\n\nReporting to the Field Reimbursement Director, Lead, the Field Reimbursement Director will optimize access to Alnylam products in his/her region by understanding and addressing reimbursement and patient access challenges. This position requires a professional who can leverage his/her technical expertise and experience to deliver educational, reimbursement in-service programs to all sites of care (Medical Doctors Office, Alternative Infusion Centers, Hospital Outpatient Department, etc.) and manage access and reimbursement issues by initiating as well as leading action plans to resolve these issues. \n\nA key component of this role is the ability to establish and deepen customer relationships through quality interactions with access and reimbursement focused external stakeholders at targeted strategic accounts. As such, extensive knowledge of \u2018buy and bill\u2019 products and prior experience with high-touch, specialty products is essential. \n\nThe Field Reimbursement Team will be a critical component of the commercial strategy and work in close coordination with National Account Leads (NALs), Strategic Account Leads (SALs), Regional Account Leads (RALs), Patient Services, Broader Reimbursement team and Sales to support Alnylam\u2019s patient-focused vision of harnessing a revolution in biology for human health.\n\nThe successful candidate must be passionate about science and deeply motivated by the quest of delivering value to patients with the long-term success of the company in mind. He/she will work collaboratively with both internal and external stakeholders to build tactical plans to execute strategic imperatives. \n\nKey Responsibilities:\n\n * Optimizes access to the full Alnylam portfolio of products by ensuring that provider accounts understand access and reimbursement dynamics\n * Proactively identifies trends impacting barriers to access or reimbursement and creates solutions \n * Works with internal stakeholders and providers to support treatment pathways for patients\n * Proactively engages with key stakeholders in accounts, including Intake/Authorization teams, billing compliance, Finance executives (Revenue Cycle, Revenue Integrity), Infusion Center management and decision-makers and key Pharmacy Stakeholders\n * Responsible for identifying, addressing and resolving outstanding claim payment issues\n * Provides guidance to case managers on case-specific complex PA/Appeal issues\n * Collaborates with case managers on treatment site finding for the specialty business when there are no site of care options available in the treatment directory\n * Provides case-specific PA/Appeal support and site of care options for the rare business\n * Maintains relationships with Medicare Administrative Contractors (MACs) to optimize coverage for Alnylam therapies and monitors Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs)\n * Works with Public Policy \u0026 Government Relations team on engagement strategies and tactics regarding MACs or local policy changes as well as state-level public policy initiatives\n * Utilizes reporting dashboards to track critical metrics and key performance indicators (KPIs)\n * Ensures compliance with all corporate and industry policies in collaboration with Alnylam Legal, Regulatory and Compliance\n\n\n\nQualifications:\n\n * Bachelor\u2019s degree required\n * 10+ years prior pharma/biotech experience\n * 5+ years of field reimbursement experience in \u201cbuy and bill\u201d preferably in rare disease or oncology\n * Established relationships with Medicare Administrative Contractors (MACs) highly preferred\n * Strong knowledge of the US payer landscape\n * Deep understanding of both medical benefit and pharmacy benefit across payer types (Medicare, Medicaid, commercial, VA/DoD, etc.) and sites of care (Hospital Outpatient Department, free standing centers and home infusion)\n * Proven ability to identify key access and reimbursement barriers to treatment and design effective resolution plans\n * Exceptional professional communication, interpersonal and problem-solving skills necessary to interact with decision makers (CFO and other C-suite level stakeholders)\n * Demonstrated ability to lead without authority in a highly collaborative matrix and fast-paced environment\n * Self-starter who is enthusiastic about rare disease and Alnylam\u2019s core values: fiercely innovative, open culture, purposeful urgency, passion for excellence, and commitment to people\n * Ability to travel up to 75%\n * Must reside in geography with reasonable proximity to a mid-size or larger airport\n\n\n\n#LI-ST1 #LI-Remote \n