Regional Director, Field Reimbursement (South Region)

Position Summary:

Reporting to the National Director of Reimbursement, the Regional Associate Director, Field Reimbursement will lead a team of field reimbursement managers responsible for supporting retina practices with patient access to Apellis’ Ophthalmology products. The vision of the team is to be the industry leader in support and education for patient access by anticipating stakeholder needs and providing expertise, connection, and empathy. This individual will use their experience and technical knowledge to help their team in identifying, understanding, and addressing reimbursement challenges that impact patient access to therapy obtained through both "buy and bill" and specialty pharmacy. As a member of the Field Leadership Team, the Associate Director (FRD) will work with cross-functional partners to create and deploy solutions within their region that drive patient access, ensuring team alignment in overall execution of strategy.  

Key Responsibilities Include:

• Develop (in conjunction with National Director) and provide clear direction to the Field Reimbursement Managers (FRMs) to ensure their daily activities are aligned with current Apellis strategies and maximize patient access.
• Foster a high-performance and forward-thinking culture in line with Apellis’ values that places an emphasis on compassion, collaboration, scientific integrity, resourcefulness, and fearlessness in the face of a challenge.
• Provide quarterly field coaching rides to every FRM with a clearly documented field coaching report to support employee development.
• Monitor FRM key performance indicators and operational data points and utilize them to coach and mentor the team.
• Promote and train to the proper use of Apellis tools, resources, and systems.
• Identify areas of training to continue to elevate individual and team business acumen and competency within access and reimbursement landscape.
• Coach team to have expert knowledge of coverage landscape within each aligned geography and patient support programs and processes.
• Establish and support local market diagnostics related to outlier payers and facilitate approach to ensure access equivalent to FDA label.
• Under the advisement of their manager, FRD will be responsible for leading specific national strategies and tactic development.
• Establish expectations for working in close collaboration with cross functional partners to facilitate ongoing feedback of team in support of shared accounts.
• Maintain strong one team relationships and collaboration by providing regular proactive cross functional communication.
• Develop FRMs into future leaders, facilitating the pursuit of developmental opportunities and by providing ongoing coaching and feedback.
• Provide feedback to Corporate Account Directors, Government Affairs/Public Policy and Account Management teams on engagement strategies and tactics regarding payers, including Medicare Administrative Contractors (MAC's), Medicare Advantage and Commercial Payers.
• Provide insight in the development of marketing tools and resources necessary to support the FRM team discussions with practices to ensure they are educated on Apellis Assist offerings, access levels, and support of practice and patient portals in tangent with external vendors
• In collaboration with Training, iterate on and execute a reimbursement learning & development plan as well as the educational content to build team members knowledge about product-specific coverage, coding and payment dynamics, Apellis support programs and other areas impacting patient and access to Apellis products.
• Ensure compliance with all corporate and industry policies in collaboration with Apellis Legal, Regulatory and Compliance.

Education, Registration & Certification:

• Bachelor’s degree required; MBA an advantage.

Experience:

• 12+ years of commercial experience in the pharmaceutical or biotech industry.
• 5+ years of experience in Healthcare Provider Reimbursement, Payer Relations or Account Management.
• 4+ years management experience demonstrating the ability to build and sustain high performing teams.
• Ophthalmology experience strongly preferred.

Skills, Knowledge & Abilities:

• Deep knowledge of “buy and bill”, Medicare Part B, medical benefit, and their associated reimbursement pathways. Deep understanding of healthcare ecosystems, reimbursement and account management approach.
• Technical expertise in ICD 10, HCPCS and cpt coding along with payer policy and reimbursement for in office administered products.
• Ability to manage and influence in a highly matrixed environment.
• Experien