Sr. Director of Government & Commercial Payer Accounts
: Job Details :


Sr. Director of Government & Commercial Payer Accounts

BTG plc

Location: all cities,PA, USA

Date: 2024-11-18T19:33:51Z

Job Description:
Come and Save Lives with Us!SERB Pharmaceuticals is a growing international specialty pharmaceutical group that is a dedicated ally to healthcare providers treating patients with critical conditions, focusing on emergency care and rare diseases. We have over 470 employees in 16 countries and a group revenue in excess of €350m.Our portfolio 80+ rescue medicines make a real difference in the lives of patients and their caregivers and that gives every one of our employees a sense of purpose.Our Purpose is supported by our 4 key values:
  • We make patients our priority
  • We act with integrity and accountability
  • We work together as one team
  • We look for better ways forward
Broad Overview We are looking for a Senior Director of Government & Commercial Payer Accounts responsible for the development and implementation of government & commercial channel strategy and tactics designed to secure, maintain, and expand appropriate access and reimbursement for all products. This person will be responsible for strategic imperatives and tactical planning for targeted government & commercial channels: CMS, Medicare Part B MACs, Medicaid, VA, DOD, Tricare and National & Regional Commercial payers. This position will facilitate access and reimbursement for products and ensure coordinated/targeted pull-through with Sales & Strategic Accounts The Senior Director of Government & Commercial Payer Accounts will maintain a high level of collaboration and integration with Sales, Strategic Accounts, Clinical Operations & Development, Medical Affairs, Legal, Compliance, Training, Finance, and Senior Leadership. This role will report to the VP of Value & Access. As Sr. Director of Government & Commercial Payer Accounts, your responsibilities will include: - Develops, implements, and manages national commercial & government channel payer strategies for all products. - Leads commercial & government channel contract design and negotiations to optimize patient and provider access and reimbursement, product performance from a patient access, safety, and profitability perspective. - Identifies immediate growth opportunities and recommends pull-through strategies. - Proactively identifies critical risk areas and develops mitigation strategies. - Coordinates with state and local legislation on payer policy initiatives. - Identifies and collaborates with key decision-makers in local public policy. - Collaborates with Marketing, HEOR, Medical, and Finance to develop value-based messaging and metrics to ensure long-term relationships with payer partners. - Builds long-term strategic partnerships and leads cross-functional support for payer initiatives, including appropriate internal, field-based, and external stakeholders. - Identifies and engages KOL support. - Develops and maintains channel-specific partnerships with Commercial Payers, Medicare Contractors, Carrier Advisory Committee (CAC) members, professional medical societies, and members/officials within the US Veteran and Military Healthcare Systems. - Serves as internal project lead to establish and execute payer initiatives in collaboration with marketing, reimbursement, sales, HEOR, and internal and external stakeholders. - Collaborates with the field, corporate account directors, and internal team to execute strategies and pull through. - Explores and assesses business opportunities for all products to increase sales revenue/profit; assessment to potentially include Trade and distribution, SP and Specialty Distributor channels, Accountable Care Organizations and Integrated Delivery Networks. - Negotiates and manages new business agreements aligned with brand strategy. - Works cross-functionally and collaboratively with Marketing, Sales, Medical Affairs, Legal, Contracting, Reimbursement, and Finance to support development and Life Cycle Management activities. - Serves as the Commercial & Government Channel subject matter expert (SME) for all internal stakeholders. The above duties and responsibilities are not an exhaustive list, and you may be required to undertake any other reasonable duties compatible with your experience and competencies. This description may be varied from time to time to reflect changing business requirements. To be successful in this role, you should demonstrate: - Bachelor's or Master's Degree required. - Minimum 10 years of pharmaceutical/biotech industry experience. - Minimum 10 years of hospital experience. - Minimum 8 years of field-based Market Access Account Management experience with a proven track record in access and reimbursement, working with biotech specialty products (Commercial Account Management, Government Account Channels, Market Access Payer Marketing, Patient/Provider Reimbursement HUB services, and some degree of coding and claims processing). - Demonstrated experience in negotiating agreements/contracts. - In-depth understanding of the functions and procedures of distribution channels, wholesalers, and specialty pharmacies, including physician buy and bill reimbursement models. - Strong understanding of payer market and payer dynamics, both commercial and government-funded, and experience in different access and reimbursement models, including Medicare Parts B and D, Medicare Advantage (e.g., Medicare Coverage Determinations (NCDs, LCDs, and Coverage Articles), ASP pricing. - In-depth understanding of Health Care Reform, Medical Policy, and the legislative arena. - In-depth understanding of coverage, coding, and reimbursement for specialty therapies across all sites of care: CMS ASP, ASC, OPPS, J, C, and Q Codes. - In-depth understanding of federal GSA contracts and pricing requirements (FSS, BPA, DAPA/E-CAT - Defense Logistics Agency). - Demonstrated success in developing and implementing targeted pull-through to maximize sales objectives with the appropriate/needed training. - Outstanding customer relationships, interpersonal and communication skills with the established ability to effectively communicate across diverse audiences and influence cross-functionally. - Ability to travel up to 50%. Company Benefits:
  • Vacation days and the ability to accrue 1 additional day of vacation earning up to a maximum of 20 day on the employee's anniversary date each year.
  • Medical, Dental, Vision and other Voluntary benefits
  • Paid Parental Leave
  • Tuition Assistance
  • Discretionary Bonus Plan
  • Competitive 401(k)
Serb Pharmaceuticals is an equal opportunity employer. We offer competitive compensation & benefit packages, challenging opportunities and a culture of working together in a supportive way built on our strong foundation of values.
Apply Now!

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