Director, Market Access and Reimbursement

  • Jersey City, NJ
  • Full-time

Company Description

Entrepreneurial Spirit, Rooted in Tradition. At Mitsubishi Tanabe Pharma Development America (MTDA), we can tout a storied reputation more than 300 years in the making. Our parent company, Mitsubishi Tanabe Pharma Corporation (MTPC), is a research-driven pharmaceutical company with global reach – and one of Japan’s oldest and most respected companies. Relatively new to the U.S. market, the innovative compounds of the Mitsubishi Tanabe Pharma Group have already enjoyed commercial success under the brand labels of our U.S. partners. In this next phase of development, we plan to bring exciting new compounds to market under our own MT Pharma America label. We’re currently building a new commercial organization and expanding our other functions to support this strategy.

The Director, Market Access and Reimbursement, will build the Reimbursement, Billing and Coding strategy to support the launch and life cycle management of our lead ALS therapy in the United States. This position will report to the Chief Commercial Officer and will be required to work closely with other members of the commercial team, including marketing, sales, trade, and sales operations, as well as other cross-functional partners.
The incumbent will be responsible for developing and executing an annual plan to achieve priorities for engagement with key external groups across franchises and functions; serving as main liaison with external non-government stakeholders and facilitating collaboration with such groups by other functions; working with Commercial, Medical, R&D, and other functions to ensure that priorities and investments with external stakeholders align with overarching business goals; and managing a budget to accomplish objectives







Job Description

Builds the Managed Markets Launch strategy for MT Pharma US’ lead ALS product; builds team both internally and externally

Serves as Payer/Reimbursement Leader and represents payer/reimbursement on the ALS launch team; drives success factors to support long-term payer and access strategy

Builds Payer Strategy and execution including the coding platform, BIM, policy for access across payers, GPO contracting, payer policy, etc.

Leads development of compelling payer value proposition that communicates clinical, economic and value based attributes of MT Pharma US therapies to key payer segments and channels

Keeps senior and corporate executives informed about changes and emerging issues in the broad, managed customer environments and subsequent implications for MT Pharma US

Works with cross-functional partners (Account Directors, Brand Marketing, Sales, HECOR, Medical, Legal, Commercial Analytics and others) to develop a comprehensive reimbursement strategy that is strategically aligned for Payer account team and reimbursement team

Manages market access marketing agency (and vendor relationships) to develop promotional programs and tactics aligned with payer launch plan

Supports Patient Services / HUB development and executes launch of patient out of pocket programs

Runs Ad Boards to drive strategy for site of care projects within market access

Develops/maintains thorough understanding of dynamics driving various managed markets segments and channels: Commercial Managed Care, Medicare, Medicaid, Exchanges, Trade, Integrated Delivery Systems/Systems of Care, Accountable Care Organizations, Value Message, ALS GPO and Institutions

Works with internal and external segment and channel experts to identify leading trends, channel dynamics and translate to impactful access programs (including GPO) for our brand

Designs and conducts research with key customer segments to aid in the development of sound managed markets business strategy

Collaborates closely with Medical Affairs and HECOR departments to ensure payer related endpoints are captured in pivotal trials/outcomes research for eventual use with decision-makers

Effectively manages budgets and project timelines including all price reporting to the government and contract management


Qualifications

Education:
Bachelor's degree in Business, Finance, Health Administration or related

MBA or MHA preferred

Professional Experience:
Minimum of 10 years experience in the Pharmaceutical/Biotech industry in managed markets, ALS, reimbursement or similar, with at least 5 years in a leadership role and 3 years in payer strategy or managed care contracting  

Experience with commercial or payer assessments for early stage pipeline programs

Track record of closing complex negotiations in payer/managed care arena

Preferred experience includes:

▬ Pharmaceutical pricing

▬ Direct payer and/or product commercialization

▬ ALS: managed market launch, policy, pricing, reimbursement and
access

▬ Risk or value based GPO contracting

▬Biotech and start-up arenas

Knowledge and Skills:
Broad based knowledge of the Pharma/Biotech industry, healthcare finance, managed care and insurer access strategies 

Firm grasp of legal, regulatory and compliance issues in the healthcare space 

Analytical/strategic thinker with proven ability to:  

▬ conduct situation analysis of external pricing and reimbursement environment; synthesize relevant information to develop strategic plans

▬ develop/test value messages and value evidence with payers; determines most compelling way to demonstrate/communicate product value to payers

▬ conduct qualitative and quantitative pricing studies; formulate price policy recommendations

▬ formulate health policy strategy; implement these strategies to shape external pricing and reimbursement environment

▬ review clinical and health economic literature, including disease state information, clinical trial design and results, and Pharmacoeconomics studies, in order to understand implications for value to payers

Strong interpersonal and internal/external relationship-building skills in order to drive change and innovation and succeed in a highly matrixed environment

Excellent oral/written communication skills, coupled with exceptional presentation skills, including ability to present to large audiences

Ability to prioritize and manage complex projects, with multiple stakeholders, and drive high-quality results within allotted budget

Highly proficient in MS Office; advanced Excel skills

Willingness to travel domestically and internationally (approximately 40%)


Additional Information

Our Value Proposition:

Enjoy the fast-moving, entrepreneurial spirit more typically found in a small biotech, complemented by the benefits of a global pharmaceutical/chemical conglomerate. At this time, Mitsubishi Tanabe Pharma Development America offers our employees unparalleled opportunities for career success coupled with a supportive level of employee benefits:

Medical/Dental | Life Insurance | Supplemental Life Insurance/Dependent Life Insurance | Accidental Death & Dismemberment Insurance | Business Travel Accident Insurance | Short-Term Disability |
Long-Term Disability | Flexible Spending Accounts | Employee’s Savings Plan (401K Plan) | Competitive Paid Time Off