Director, Payer Access & Reimbursement

Director, Payer Access & Reimbursement

• Company Gamida Cell, Inc.
• Posting
  
  Title:
  
  Director, Payer Access & Reimbursement
• Function:
  Market Access, Commercial

Gamida-Cell Inc., an Ayrmid Pharma Ltd. company, is amid a period of transformational growth with a focus on commercializing novel treatments for rare, specialty, and oncological diseases with high unmet need. In support of this evolution, Gamida-Cell is seeking to bring people into the company who have a passion for both helping patients and building corporate capabilities. Are you ready to assist us on that journey?

Join us and be instrumental in our growth!

Gamida Cell is a leader in advanced cellular therapies and hematopoietic stem cell transplants, with two FDA approved therapies, Omisirge ® (omidubicel-onlv) and APHEXDA ® (motixafortide). Omisirge® is the first and only FDA approved cell therapy for allogeneic stem cell transplant. APHEXDA® is a stem cell mobilization agent indicated for autologous transplantation for patients with multiple myeloma.

General Scope and Summary

The Director, Payer Access & Reimbursement plays an important role in securing timely access to therapies for patients and will collaborate cross functionally with the medical affairs, account management, and cell therapy operations teams to support transplant centers. The core function of the role is to operationalize the overall payer and hospital administrator strategy to ensure appropriate patient access to therapies.

The Director, Payer Access & Reimbursement will ensure coverage and access at the payer level as well as educate hospital administrators on appropriately accessing Gamida Cell’s therapies and on relevant coverage and reimbursement policies.

The Director, Payer Access & Reimbursement will report to AVP, Head of Market Access.

Roles and Responsibilities

• Obtain positive coverage and access for Gamida Cell products with national, regional and government payers within assigned region
• Educate hospital administrators (C- suite level, billing and reimbursement personnel, chargemaster personnel) on appropriate formulary, access, coverage, coding requirements and payment methodology for Gamida Cell products to build reimbursement confidence
• Negotiate trade agreements with Treatment Centers as needed
• Provide assistance supporting the entire patient access journey, from physician order to reimbursement, including payer policy development, prior authorization to appeals/denials requirements and procedures, and appropriate coding and billing support
• Build proactive relationships with organizations/KOLs whose experience and expertise are relied on by payers
• Assess payer and state policy landscape to understand potential impact to coverage of Gamida Cell’s products for Commercial, Medicare and Medicaid patients
• Develop and implement payer account level business plans and contribute to overall hospital account business plans
• Responsible and accountable for the successful implementation within region of the strategic and tactical market access plan
• Present / provide approved product education and health economic information to key customers and communicate the value proposition of Gamida Cell’s products
• Partner with internal and external stakeholders, including business solutions, Gamida Cell Assist and other partners to onboard sites, address access related inquiries and execute on strategic account plans
• Identify and mitigate potential challenges that may hinder access
• Establish critical relationships with a variety of stakeholders within geography: key transplant centers, Medicare CMDs, health plan medical directors and state Medicaid directors

Experience, Education and Specialized Knowledge and Skills

• Demonstrated successful experience with National, Regional and/or…