This role is considered Virtual.
Overview
Reporting to the Field Reimbursement 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.
A 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 ‘buy and bill’ products and prior experience with high-touch, specialty products is essential.
The 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 and Sales to support Alnylam’s patient-focused vision of harnessing a revolution in biology for human health .
The 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 on the strategic imperatives.
Key Responsibilities
- Optimizes access to Alnylam products by ensuring that provder accounts understand access and reimbursement dynamics
- Proactively identifies trends impacting barriers to access or reimbursement and creates solutions
- Works with internal stakeholders and providers to support treatment pathways for patients
- Proactively identifies trends impacting barriers to access or reimbursement and creates solutions
- Responsible for addressing and resolving outstanding claim payment issues
- Provides guidance to case managers on case-specific complex PA/Appeal issues
- 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
- Provides case-specific PA/Appeal support and site fo care options for the rare business
- Maintains relationships with Medicare Administrative Contractors (MACs) to optimize coverage for Alnylam therapies and monitors Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs)
- Works with Public Policy & Government Relations team on engagement strategies and tactics regarding MACs or local policy changes as well as state-level public policy initiatives
- Utilizes reporting dashboards to track critical metrics and key performance indicators (KPIs)
- Ensures compliance with all corporate and industry policies in collaboration with Alnylam Legal, Regulatory and Compliance
Qualifications
- Bachelors degree required
- 10+ years prior pharma/biotech experience
- 5+ years of field reimbursement experience in ‘buy and bill’ preferably in rare disease or oncology
- Established relationships with Medicare Administrative Contractors (MACs) highly preferred
- Strong knowledge of the US payer landscape
- 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)
- Proven ability to identify key access and reimbursement barriers to treatment and design effective resolution plans
- Exceptional professional communication, interpersonal and problem-solving skills necessary to interact with decision makers (CFO and other C-suite level stakeholders)
- Demonstrated ability to lead without authority in a highly collaborative matrix and fast-paced environment
- Self-starter who is enthusiastic about rare disease and Alnylam’s core values: fiercely innovative, open culture, purposeful urgency, passion for excellence, and commitment to people
- Ability to travel up to 75%
- Must reside in Northern CA, NV or UT
About Alnylam: Alnylam Pharmaceuticals (Nasdaq: ALNY) has led the translation of RNA interference (RNAi) into a whole new class of innovative medicines with the potential to transform the lives of people afflicted with rare and more prevalent diseases. Based on Nobel Prize-winning science, RNAi therapeutics represent a powerful, clinically validated approach to treating diseases at their genetic source by “interfering” with mRNA that cause or contribute to disease. Since our founding in 2002, Alnylam has led the RNAi Revolution and continues to turn scientific possibility into reality.
Our culture: Our people-first culture is guided by our core values: fiercely innovative, open culture, purposeful urgency, passion for excellence, and commitment to people, and these values influence how we work and the business decisions we make. Thanks to feedback from our employees over the years, we’ve been fortunate to be named a top employer around the world. Alnylam is extremely proud to have been recognized as one of Science Magazine’s Top Biopharma Employers, one of America's Most Responsible Companies for 2024 by Newsweek, a Fast Company Best Workplace for Innovators, and a Great Place to Work in Canada, France, Italy, Spain, Switzerland, and UK – among others.
At Alnylam, we commit to an inclusive recruitment process and equal employment opportunity. We are dedicated to building an environment where employees can feel that they belong, can bring their authentic selves to work, and achieve to their full potential. By empowering employees to embrace their unique differences at work, our business grows stronger with advanced and original thinking, allowing us to bring groundbreaking medicines to patients.
