National Director of Reimbursement and Reimbursement Policy

Title:

Company:

Ipsen Biopharmaceuticals Inc.

Job Description:

The National Director of Reimbursement & Reimbursement Policy reports to the VP of Value and Access. This is a dual role leading the field based Regional Reimbursement Directors (RRD) team as well as leading V&A engagement on reimbursement regulations. The incumbent will lead and define the future market access capabilities with our evolving portfolio based on the changes of the U.S. healthcare landscape, various federal and state policy reform, payer economics and payer innovation. Using actionable insights and analytics he/she will drive the implementation, execution and measurement of strategies to increase access for patients to Ipsen’s current and future product pipeline products and improve Ipsen’s long term competitive success in the US.

This position will have 8 direct reports that are field based Reimbursement Directors.

Main Responsibilities & Expectations

Deploy field-based Regional Reimbursement Directors (RRDs) to provide appropriate access and reimbursement support to Ipsen Customers, interface with Medicare Administrative Contractors (MACs), and advocate for appropriate access.
Develop strategies in collaboration with Value & Access team and Government Affairs to influence Medicare, Medicaid, 340B, commercial payer policy, coding impact, and access support initiatives.
Translate federal and state law and regulation into operational V&A strategies and tactics.
In collaboration with Government Affairs, monitor and assess impact of emerging policy threats and opportunities and identify trends and policy changes that may impact Ipsen’s current and future pipeline, including but not limited to changes in commercial reimbursement changes, changes to government programs (i.e., Medicaid, Medicare, 340B), new payment models, innovative pricing strategies, potential consolidations in the US healthcare landscape and ever-changing coverage/reimbursement model.
Lead and support cross-functional teams to develop policy alternatives to proposed legislation and regulation of, and reimbursement for, prescription products, or otherwise impacting V&A strategies and operations.
Provide V&A subject matter expertise for efforts to shape legislation and regulatory programs Support engagement of V&A subject matter experts in PhRMA or other trade associations.
Identify and translate reimbursement trends that could impact access to product portfolio
Develop reimbursement strategies / tactics to capture business opportunities and mitigate challenges impeding product growth
Research and interpret national and local Medicare, Medicaid, and private payer coverage policies, coding requirements, and utilization controls for Ipsen products as well as competitor products
Develop working relationships with CMS, HRSA, and MACs
Assess and influence new product coverage, coding, and payment strategy to optimize commercialization and reimbursement
Oversee the development of reimbursement training materials for internal and external customers

Knowledge, Abilities & Experience

BA/BS is required; and advanced degree is preferred as is certified coding background
10+ years of pharmaceutical / biotech reimbursement experience, including recent focus on CMS and HRSA regulatory actions and policy changes
Several years experience leading field-based reimbursement support teams that interface with Medicare Administrative Contractors (MACs)
Experience managing vendors and getting results and reports from outsourcing partners
Advanced knowledge and experience in Medicare (Part A, Part B, Part C, and Part D), Medicaid, private payer policies, reimbursement process, health policy, areas of coverage, payment, coding, SPP, and buy & bill.
Experience leading and motivating a large-scale team and track record in strong development of people through management and leadership
Well-developed leadership skills – comfortable managing direct reports in the US; proven ability to grow and develop others

#LI-Hybrid

IPSEN is an equal opportunity employer that strictly prohibits unlawful discrimination. We recruit, employ, train, compensate, and promote without regard to an individual’s race, color, religion, gender, sexual orientation, gender identity/expression, national origin/ancestry, age, mental/physical disability, medical condition, marital status, veteran status, or any other characteristic protected by law.

IPSEN Glassdoor Company Review

3.9