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Director, Market Access & Reimbursement - North Central

Company: Pacira Pharmaceuticals
Location: Milwaukee
Posted on: June 12, 2021

Job Description:

About Pacira

Pacira BioSciences, Inc. is a leading provider of non-opioid pain management and regenerative health solutions dedicated to improving outcomes for health care practitioners and their patients. Our in-depth knowledge of non-opioid pain management, coupled with our passion for advancing patient care, drives our commitment to providing solutions that address unmet medical needs and improve clinical results.

Why work with us?

Rarely do you have an opportunity to do work that really matters. What drives us is our mission. What makes us successful are our people. At Pacira, you are part of an inclusive culture that fosters collaboration, growth, and innovative thinking - a place where you can make an impact and help change the standard of care in non-opioid pain management. Be part of our movement, let's pursue excellence together.

Essential Duties & Responsibilities:

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 Payers.
  • 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
  • An entrepreneurial mindset.
  • Demonstrated understanding of CMS, Commercial payment models and trends.
  • 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 structure.
  • 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 levels.
  • 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 Environment:

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.

EEO Statement

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.

At Pacira we are committed to intentionally cultivating a culture of inclusion where all feel welcomed and valued for their background, perspectives, and experiences. We hold one another accountable to promote trust and transparency in support of our communities and collective purpose.

Keywords: Pacira Pharmaceuticals, Milwaukee , Director, Market Access & Reimbursement - North Central, Other , Milwaukee, Wisconsin

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