Associate Director, Field Reimbursement - Northwest Region
Core
Optimize access to Alnylam's specialty product portfolio by resolving reimbursement barriers and managing patient access challenges across the Northwest region.
Role type
Associate Director, Field Reimbursement
Builds
Patient treatment pathways and coverage solutions for high-touch specialty products
Domain
Biotechnology / Specialty Pharmaceuticals / Rare Disease
Deliverable
client delivery
Required skills
US payer landscape knowledge, medical and pharmacy benefit expertise, Medicare Administrative Contractor (MAC) relationships, claim payment issue resolution, strategic account management, policy engagement, KPI tracking, compliance management
Preferred skills
Experience in rare disease, oncology, or infusion/injectable products, established MAC relationships
Technologies
Reporting dashboards
Responsibilities
Optimize access to the full Alnylam portfolio by ensuring provider accounts understand access and reimbursement dynamics; Proactively identify trends impacting barriers to access or reimbursement and create solutions; Work with internal stakeholders and providers to support treatment pathways for patients; Proactively engage with key stakeholders including billing compliance, Finance executives, Infusion Center management, and Pharmacy Stakeholders; Identify, address, and support education to resolve outstanding claim payment issues; Provide mentorship and guidance to case managers and field reimbursement managers on complex PA/Appeal issues; Provide case-specific PA/Appeal support and site of care options for the rare business; Maintain relationships with MACs to optimize coverage and monitor Local and National Coverage Determinations; Work with Public Policy & Government Relations on engagement strategies regarding MACs or local policy changes; Utilize reporting dashboards to track critical metrics and KPIs; Ensure compliance with all corporate and industry policies.
Seniority
Senior, hands-on IC