Director, Market Access & Reimbursement - North Central
Company: Pacira BioSciences, Inc
Location: Saint Paul
Posted on: April 3, 2021
Director, Market Access & Reimbursement - North Central Payers &
Reimbursement Milwaukee, WI Ann Arbor, MI Grand Rapids, MI
Lexington, KY Louisville, KY Chicago, IL Des Moines, IA Kansas
City, MO Madison, WI Minneapolis, MN Naperville, IL St. Paul, MN At
Pacira Pharmaceuticals, controlling postsurgical pain is the key to
improving patient outcomes. Our in-depth knowledge of the needs of
the postsurgical pain market, coupled with our passion for
delivering improved patient care, drives our commitment to
providing solutions that address unmet medical needs and improve
clinical results. The Director, Market Access and Reimbursement is
a customer facing role and will report to the Sr. Director, Market
Access. This role is responsible for representing Pacira, and the
value of its products to various types of Payers and Employers.
Gaining their support for product reimbursement and coverage by
removing "roadblocks" is the primary focus. This person will be the
Pacira interface with targeted payers including but not limited to
commercial payers, workers' compensation programs and State and
Federal governments. Understanding quality and pay for performance
metrics associated with them, building relationships and finding
collaboration opportunities is essential to advance Pacira products
and initiatives. This position will represent Pacira's interests to
build and manage relationships with high level influencers with
National and regional payers as well as their networks, including
ACOs, ASC Chains, HOPD's and targeted Consulting Groups. This
person will also be the internal expert advising, teaching,
coaching and building support material for internal groups on
matters of coding, coverage, billing and reimbursement as it
relates to their respective geography.-- Job Responsibilities:
- Remove obstacles with respect to Coding, Coverage and
Reimbursement that prevent patient access to Pacira products.
- Identify and implement opportunities to collaborate with
- Work with various associations such as ASCA, AMCP, NAHPC, third
party consultants and other payer and provider networks to find
opportunities to educate the payer community about the value of
Pacira products. Clearly deliver the products value message,
understand the current reimbursement methodology and recommend
changes needed to obtain unrestricted access for patients.
- Attend various conferences.
- Work closely with internal partners on pull-through
opportunities with Payer customers on messaging and resources
required to maximize patient access.
- Be the internal "go-to" resource for reimbursement questions
from field and HQ.
- Continuously maintain a compliant environment. Interaction:
This position will work closely with internal departments, such as,
Marketing, Field Sales, National Accounts, Medical Affairs, and
with external consultants. Qualifications:
- Current and relevant working relationships with executive level
decision makers at payers, Associations and Coalitions
- Demonstrated understanding of CMS, Commercial payment models
- An in-depth understanding of the payer's process & medical
policy (not just pharmaceuticals) that has resulted in successfully
improving market access.
- Understanding medical billing, coding, appeals, denials and
single case rates a plus.
- Demonstrated ability to partner, communicate, and accomplish
goals across the organization without direct reporting
- Proven ability to think strategically and succeed with limited
structure and direction.
- Proven problem-solving, analytic and negotiation skills with
high value contracts and partnerships.
- Excellent written and verbal English communication skills
including presentation skills to groups of all sizes at executive
- Valid driver's license in the state in which you reside
Education and Experience:
- Bachelor's degree from an accredited college or university in
Health Policy, Finance, Business or other related fields.
- Minimum of 5-10 years related experience in the healthcare
industry. Sales management a plus.
- Minimum of 5 years of relevant experience particularly managing
national and regional payer and/or employer corporate
relationships. Physical Demands: While performing the duties of
this job, the employee is regularly required to sit, talk, move
between spaces, reach with hands and arms, and stoop. Close vision
and the need to focus on computer screen, use of hands, fingers and
wrist to type on keyboard and manipulate mouse.-- **Ability to
travel 70% plus Work from home or remote locations such as
airports, hotels and off-site meetings. This position may or may
not be a typical office setting, staff in cubicles. Noise level is
moderate such as consistent printer, telephone ringing,
conversation, airport paging and airplane noise.-- Pacira is proud
to be an Equal Opportunity Employer and does not discriminate
against applicants because of race, color, religion, sex (including
gender identity, sexual orientation, and pregnancy), national
origin, age (40 or older), veteran status, disability or genetic
information, or any other characteristic protected under applicable
federal, state, or local law. You have been redirected to a Pacira
BioSciences, Inc. job page
Keywords: Pacira BioSciences, Inc, St. Paul , Director, Market Access & Reimbursement - North Central, Executive , Saint Paul, Minnesota
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