Director, Field Reimbursement

Inizio Engage has a long-standing partnership with a leading Biotechnology company, across Commercial, Patient Solutions and Medical Affairs businesses.

The Director, Field Reimbursement will be directly responsible for driving market development and serving as the subject matter expert of the Field Reimbursement Manager (FRM) function within the Patient Access specialty area. The Director, Field Reimbursement develops and implements reimbursement strategies and programs to obtain coverage, coding, and payment from payer/providers in alignment with client guidelines. They provide reimbursement-related advice to product development teams, marketing, commercial, regulatory, market access and business leaders. Identifies payer opportunities and issues and implements programs to resolve/decrease barriers to entry for the company's products or therapies. May create training and deliver education programs to a myriad of industry eco-system partners including but not limited to case managers, healthcare institution C-suite, physicians, billing managers, biologics coordinators, sales force, specialty pharmacies, home care agencies and pharmacists within clinics and hospitals.

The Director, Field Reimbursement will be a key member of the Patient Solutions leadership team. This role reports to the Executive Director, Patient Solutions.

This is your opportunity to join Inizio Engage and represent a top biotechnology company!

What’s in it for you?

Competitive compensation

Excellent Benefits – accrued time off, medical, dental, vision, 401k, disability & life insurance, paid maternity and paternity leave benefits, employee discounts/promotions

Employee discounts & exclusive promotions

Recognition programs, contests, and company-wide awards

Exceptional, collaborative culture

Best Places to Work in BioPharma (2022, 2023, & 2024)

Certified Great Place to Work (2022, 2023, 2025)

What will you be doing?

Lead overall function of Field Reimbursement on behalf of client manufacture programs. This includes support of the Ashfield business development function is response to RFI/RFP and pitch process.

Partner with lead generators (i.e. Account Executive, New Business Partner) to pursue and win new opportunities

Identify trends in client requests and partner with Specialist Area leaders to adapt products to client needs over time

Work closely with Market Access, Payer teams and/or Commercial Leadership to inform access strategy and appropriately support health care providers with their reimbursement needs

Work on designated projects that are within the scope of services for Patient Access as assigned and/or consistent with developmental plans & strengths

Partner with Quality and Compliance closely to ensure compliance in the design and delivery of Patient Access/Field Reimbursement programs

Understand and be able to coach at an expert level with reimbursement issues that work within our core classes of trade:

-Commercial Managed Care (Regional Plans)

-Medicaid (Fee for Service, Managed Care Organizations)

-Medicare (Part A, B, C, D; Carriers)

-Veteran’s Administration (VISNs)

-TRICARE Regional Offices

-Specialty Pharmacy & Pharmacy Benefit Managers

-ACOs and other Integrated Delivery Networks (IDNs)

-Advocacy, consumer, provider and treatment systems groups

Follows all requirements associated with compliance to program guidelines and relevant regulations, including HIPAA and patient privacy

What do you need for this position?

Bachelor’s degree or equivalent experience required

10+ years in commercial life sciences (pharma or biotechnology) or related industry, required

Demonstrated successful selling experience in and around the pharmaceutical, biotech and medical device arena (selling service solutions to pharma, biotech and medical device clients preferred).

5+ years of experience leading field & virtual reimbursement teams

Proven experience in building and managing reimbursement and access teams; including developing and identifying capabilities, strategies, tools, key account targets, size, structure, programs/initiatives, compliance requirements (including around PHI), KPIs, analytics, integration with HUB services and client or 3rd party support services in order to effectively navigate the complexities of the US Healthcare System

Strong knowledge and understanding of:

Government and commercial payers for specialty products; especially as it relates to buy and bill and specialty pharmacy products

Payer reimbursement models (medical and pharmacy), prior authorization and appeal requirements, coding changes, appropriate claim submission, integration of HUB and patient assistance programs

Manufacturer compliance requirements for delivery of field or virtual reimbursement support services

Strong business acumen with an ability to quickly analyze data, identify meaning of data, and develop solutions to build on opportunities and overcome challenges

Proven ability to effectively manage ambiguity; can successfully cope with change, shift gears comfortably, decide and act without having the total picture, and manage risk and uncertainty

Demonstrated ability to develop innovative solutions, understands how to do the research to uncover missing information, and enjoys the challenge of being a solution architect

Maintains compliance with program business rules, standard operating procedures and guidelines

Passionate about learning and able to share/communicate that passion to others

Location:

This is a remote position. The jobholder may be required to travel up to “50%” of the time to client sites or Inizio’s Headquarters in Yardley, Pa.

About Inizio Engage

Inizio Engage is a strategic, commercial, and creative engagement partner that specializes in healthcare. Our passionate, global workforce augments local expertise and diverse mix of skills with data, science, and technology to deliver bespoke engagement solutions that help clients reimagine how they engage with their patients, payers, people and providers to improve treatment outcomes. Our mission is to partner with our clients, improving lives by helping healthcare professionals and patients get the medicines, knowledge and support they need.

We believe in our values: We empower everyone/We rise to the challenge/We work as one/We ask what if/We do the right thing, and we will ask you how your personal values align to them.

To learn more about Inizio Engage, visit us at:

Inizio Engage is proud to be an equal opportunity employer. Individuals seeking employment at Inizio are considered without regards to age, ancestry, color, gender, gender identity or expression, genetic information, marital status, medical condition (including pregnancy, childbirth, or related medical conditions), mental or physical disability, national origin, protected family care or medical leave status, race, religion (including beliefs and practices or the absence thereof), sexual orientation, military or veteran status, or any other characteristic protected by federal, state, or local laws. Further, pursuant to applicable local ordinances, Inizio will consider for employment qualified applicants with arrest and conviction records.

Inizio Engage is an equal opportunity employer M/F/V/D. We appreciate your interest in our company, however, only qualified candidates will be considered.

Full Time