orcabiosystems - Payer Account Director - Southeast
Requirements
• Bachelor’s Degree • 12+ years related Payer/Hospital reimbursement experience in the healthcare industry • Proven relationships with Commercial Payer Medical Directors, Medicare Part A, State Medicaid, and Managed Medicaid stakeholders • Strong analytical skills with experience in Payer Case rates, Payer policy development, and Payer Policy data tracking tools • Problem solving skills and multi-tasking experience are critical • Proactive, results-oriented, collaborative, self-starter with demonstrated strong leadership skills and experience in a complex reimbursement environment • Excellent presentation skills, both written and verbal • Knowledge of regulations and laws governing the protection of patient identifying information, OIG, FDA, and CMS policies pertaining to access • Must be a true team player and work collaboratively with key internal stakeholders • High level of proficiency in Microsoft Excel, Word and Power Point is required • Open to frequent travel during site onboarding process and ad hoc meetings (~40%) • The anticipated annual salary range (listed above) for this job is based on prior experience in the role/industry, education, location, internal equity, and other job-related factors as permitted by law. For remote-based positions, this range may vary based on your local market. Full-time employment positions will also be eligible to receive pre-IPO equity and annual bonus, in addition to competitive medical, dental, and vision benefits, PTO, 401(k) plan, life and accidental death and disability coverage, and parental leave benefits. Other perks include subsidized daily lunches and snacks at our on-site locations.
Responsibilities
• Serves as single-point-of-contact for all Authorized Treatment Centers (ATCs) with respect to field-related payer-access engagements (including onboarding) as identified by Orca Pod • Develop and execute Payer Strategy for assigned regional and national payer accounts, state Medicaid agencies, and Medicare Administrative Contractors to secure access to Orca products, as well as on-going payer segmentation and business strategy tactics • Present analysis of scientific data, clinical practice goals, guidelines, and anticipated economic program outcomes to support product value proposition • Utilize clinical expertise of Medical Science Liaisons or medical providers in delivering comprehensive product and disease state presentations to key decision makers. • Deliver and maintain favorable access, advantageous payer medical policy, and appropriate reimbursement for Orca products at regional & national payer accounts throughout the life cycle management of Orca’s portfolio. • Accountable for partnerships with targeted Academic Hospitals/Health Systems to ensure patient access for Orca products on a case-by-case basis, as needed • Frequent interactions with Orca’s Case Management team to resolve patient access issues • Track KPIs and ensure accuracy of dashboards to measure account market access results • Must adhere to Orca Bioscience’s core values, policies, procedures, and business ethics. • Perform miscellaneous duties as assigned.
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