Director, Field Access and Reimbursement - Remote, United States
5 hours ago
Job description
Description
Ardelyx is a publicly traded commercial biopharmaceutical company founded with a mission to discover, develop and commercialize innovative first-in-class medicines that meet significant unmet medical needs. Ardelyx has two commercial products approved in the United States, IBSRELA (tenapanor) and XPHOZAH (tenapanor). Ardelyx has agreements for the development and commercialization of tenapanor outside of the U.S. Kyowa Kirin commercializes PHOZEVEL (tenapanor) for hyperphosphatemia in Japan. A New Drug Application for tenapanor for hyperphosphatemia has been approved in China with Fosun Pharma. Knight Therapeutics commercializes IBSRELA in Canada.
Position Summary:
The Director, Field Access and Reimbursement is responsible for providing strategic leadership and operational oversight to a team of field reimbursement managers (FRMs) across a multistate geography. This role ensures patient access to company products by developing and executing field reimbursement strategies, educating healthcare providers (HCPs) on coverage and coding, and resolving access barriers within a complex healthcare landscape. The Director will serve as a key subject matter expert on the regional payer landscape, collaborating cross-functionally with internal stakeholders to align field activities with overall brand and business objectives.
Responsibilities:
- Hire, train, and develop a high performing FRM team to engage with customers about access and reimbursement challenges and resolve patient cases
- Ensure understanding of performance metrics and consistent execution of metrics across all team members
- Motivate the FRM team to build strong customer relationships, provide education for the Ardelyx patient assistance services, and compliantly deliver reimbursement support to accounts
- Coach team members to ensure maximum performance, increase access and reimbursement acumen, and collaborate with sales counterparts
- Ensure all team activities strictly comply with all regulatory, legal, and compliance standards, including HIPAA and OIG guidelines
- Develop and execute an overarching field access and reimbursement strategy for the assigned region, aligning plans with brand priorities and corporate objectives to drive measurable outcomes and maximize patient access
- Partner closely with Market Access, Sales, Marketing, Medical Affairs, Legal, and Patient Support Hub teams to ensure seamless execution and alignment of strategies
- Oversee the team's efforts to proactively educate providers and office staff on patient support programs, coding, billing, and prior authorization requirements to help resolve reimbursement challenges and integrate product use into office workflows
- Oversee the team's efforts to proactively educate providers and office staff on patient support programs, coding, billing, and prior authorization requirements to help resolve reimbursement challenges and integrate product use into office workflows
- Maintain deep expertise in the dynamic regional and local access and payer landscape (Commercial, Medicare, Medicaid), anticipating changes in healthcare policy and reimbursement regulations that may impact product access
- Train FRMs about technical policies, systems, and processes that impact access to Ardelyx products
- Bachelor's degree, Master's degree preferred, with 10+ years of progressive experience in field reimbursement, patient services, market access, or related functions within the pharmaceutical/biotech industry or equivalent experience
- 3+ years of experience as an Access and Reimbursement Manager or 3 years of field based first line leader experience
- Demonstrated ability to lead without direct authority and drive momentum in a highly matrixed environment
- Exceptional problem-solving, analytical, strategic thinking, and communication skills, with the ability to present complex information to C-level account executives and internal leadership
- In depth experience navigating payer policies and knowledge of payer processes and systems for specialty products
- Deep understanding of both medical and pharmacy benefits, coverage policies, buy-and-bill, and specialty pharmacy reimbursement pathways
- Demonstrated leadership in a matrixed environment
- Valid driver's license required
- Ability to travel up to 75% for field ride along, HQ visits, conferences, etc.
- This position covers states VA, NC, SC, GA, AL, FL
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