Regional Business Director, Field Reimbursement - Gulf Coast

Regional Business Director of Field Reimbursement (Gulf Coast)

The Region Business Director of Field Reimbursement is a field based leadership role supporting the market access strategy for the Sun family of products across the branded business units. This role provides leadership related to health policy, reimbursement, patient access and coverage within an assigned geography managing a team of approximately 7 Field Reimbursement Managers. The person in this role will lead their team of Reimbursement managers supporting primarily the Biologic Dermatology Business Unit, the Specialty Dermatology Business Unit, and the Oncology Business Unit.

In this role this individual will serve as a field subject matter expert on access and reimbursement, coding, coverage, payer processes, and payer policies. This individual will have a deep knowledge of U.S. payer landscape and understand the changes associated with Health Care Reform as it relates to patient coverage. As an expert in patient access and coverage the Region Business Director will be expected to have extensive knowledge of local, regional and national payer policies.

Their expertise needs to include strong understanding of government and commercial payers, the buy and bill process, working with alternate sites of care, appeals and exceptions processes, CMS coverage determination updates, HUB support and field operations. This individual will need to have a strong ability to manage complexity and work in a dynamic, fast‑paced business environment. Finally, this individual will be the technical expert coaching their team members on appropriate coding guidelines, CPT, J‑code, and Diagnosis code utilization while elevating their understanding of the market access landscape.

The Region Business Director will be critical in the process to identify, triage, and elevate reimbursement issues to the appropriate internal and external stakeholders.

These individuals will support all Market Access initiatives within the field such as coding and coverage, providing approved practice/patient materials, executing on Access In‑Services and Access and Reimbursement Speaker’s programs. This individual will need exceptional knowledge of medical benefit, pharmacy benefit, buy and bill products, coding and coverage as it relates to the products supports for the above mentioned teams.

Furthermore this individual should understand the critical medical societies, and spheres of influence which are important to the business needs of the business units they support. Staying abreast of key policy changes or updates will be essential in this role.

The RBD will need an exceptional understanding of Compliance issues as it relates to Market Access job responsibilities and the ability to provide clear and strong guidance to a field team as it relates to these Compliance boundaries.

Prior experience and knowledge of the complexities of pull through for biologics, oncolytics, injectable, infusible, and oral therapies is preferred.

This individual will serve as a field leader within the Market Access function and is responsible for providing direction and feedback to the Field Reimbursement team members. As a Strategic Leader this individual will be required to have exceptional presentation skills, outstanding oral and written communication skills, and strong interpersonal skills. This position will help the members of their team create local strategic plans outlining access opportunities and devise the tactics and strategies to pull through all appropriate initiatives.

This position will support the National Lead when providing direction to the Field Reimbursement team. As a RBD this business lead will need to be the example of collaboration encouraging routine communication and partnership with other internal stakeholders. These critical business partners include:
Strategic Market Directors, National Account Directors, Territory Managers, Region Sales Managers, Corporate Account Directors, and National Sales Directors.

A major portion of this role will be spent in the field coaching and…