• RAM - Market Access & Reimbursement - New England Area

    Location US-MD-Columbia
    Job ID
    2018-1254
    # Openings
    3
    Category
    Reimbursement
  • Primary Purpose of Position

    The Regional Account Manager (RAM) partners with customers to ensure Osiris product coverage providing patients access to needed medical therapies. RAMs are responsible for coverage and access; within an assigned region. Duties include the implementation and execution of all corporate Market Access business objectives in the assigned region. This is a remote positon with the following regions avialable: New England

    Principal Responsibilities

    RSPONSIBILITIES and duties include, but are not limited to
    • RAM will be responsible for the implementation and development, of payer coverage and reimbursement strategies designed to secure appropriate access, coverage and reimbursement for the Osiris products portfolio in an assigned region. • In this role, the RAM will develop and maintain relationships within “Managed Care Organizations” who have responsibility for influencing and product selection and access decisions.
    Primary customers include: • Regional and national payor professionals focused on evidenced based outcomes, including Medical Directors, Medical Policy, Case Management, QA Directors, Executives and other decision-makers within Health Insurance Plans, Managed Care Organizations, Accountable Care Organizations, and various Organized Customer Models operating within the assigned region.
    The RAM must have a good understanding of the business needs and the ability to develop the value proposition specific to the needs of Osiris and its client stakeholders. The RAM serves as an expert consultant to both the internal and external stakeholders. The RAM will develop strategies in collaboration with National and Government Access Directors, where applicable, that will help maximize relationships.
    Product/Value Presentation
    • Demonstrate product value to key regional accounts to secure Osiris product preference and maintain/grow access to drive sustained value of the portfolio by positioning products based on clinical outcomes and value. • The RAM will maintain customer profiles, communicate organizational changes, monitor/manage the competitive environment in assigned region maintaining strategic relationships with relevant commercial and medical partners. • This information will be maintained in the company customer relationship system.
    Analytics/Business Case Development, Coverage and Pull Through
    • Monitor and analyze account information for Osiris products relative to competitors and develop tactics to enhance sales. o This includes the creation of coverage business cases, the negotiation of the actual contracts, and the creation of subsequent contract pull through opportunities. • Use analytic tools, and relevant models to identify issues and opportunities associated with product performance (in assigned accounts) and create plans to address. • Track performance of existing initiatives and make sound business decisions to maximize ROI. • Be actively involved and collaborate with National and Government Access Directors, Strategy and operations and Market Access leadership on coverage decisions and ongoing payer performance.

    Additional Responsibilities Include

    • Adherence to all compliance rules and regulations • Execute POA and accurately capture field activity within sales reporting systems • Effectively deliver product specific messages • Develop and implement account specific business plans • Analyze sales trends, and interpret customer performance • Participate in training as required
    • Developing and executing sustainable business plans to ensure payor coverage and reimbursement access strategies are aligned with both corporate and regional business objectives.
    • Implementing regional strategies to support physician and facility customers through identification of coverage issues, defining solutions creating successful outcome through follow through on successful payment and meeting customer business objectives.
    • Providing regional sales support for regional Specialists and Directors.
    • Partnering with Health Policy and Market Access team in resolving Medicare, Medicaid, and Commercial reimbursement barriers and challenges.
    • Collaborating with Marketing, Sales, and Clinical and Reimbursement teams to anticipate market needs for development of tools/tactical elements necessary to maximize patient access, optimize claim submission and appropriate reimbursement. • Work with other members of the market access or field management colleagues to address regional business issues. Mentor, train and consult with internal colleagues to drive awareness and execute the regional account plan. Collaborate with other RAMs, Area Sales Teams and Marketing to ensure proper and effective implementation of all company and customer initiatives.
    • Researching complex reimbursement issues, delivering potential solutions to denied or underpaid claims.
    • Tracking regional reimbursement methodologies and trends to support strategic and tactical planning.
    • Supporting relationships with local physician champions to support interactions with hospital administrators and /or national payer organizations.
    • Creating and maintaining reimbursement and patient assistance marketing collateral and training material, ensuring that these are in accordance with SOPs and any changes therein.
    • Developing and presenting reports and data as requested by the executive management team.

    • Performing other duties as assigned.

     

    Qualifications

    QUALIFICATIONS:
    Required
    • Bachelor's degree from an accredited university or college in business, management, healthcare administration or related field.
    • Minimum of 5 years of related experience in healthcare sales, account management, managed markets or reimbursement.
    • Demonstrated responsiveness and sense of urgency when pursuing goals and completing tasks.
    • Outstanding interpersonal skills, including developing relationships at all levels in an organization and directly influencing business objectives.
    • Proven track record of working with providers and payers to provide reimbursement support and resolve reimbursement issues.
    • Understanding of medical device, biologic or pharmaceutical industry reimbursement environment.
    • Ability to understand and explain complex disease state information, clinical outcomes data and scientific product information.
    • Demonstrated ability to set and manage priorities as well as manage multiple projects.
    • Ability to work with ambiguity and continuously adapt in a rapidly changing atmosphere.
    • Understanding of hospital financial systems and management practices.
    • Working knowledge of CMS' codes, rules, regulations, pronouncements, and applicable Medicare Administrative Contractor (MAC) polices (e.g. Local Coverage Determinations), Medicaid, and commercial policies.
    • Ability to travel up to 65%
    Preferred
    • Experience working with new medical technologies in the medical device, biologic, or pharmaceutical arena
    • Experience calling on managed care organizations


    Osiris Therapeutics, Inc. is an Equal Opportunity Employer with a commitment to diversity. Applicants are considered on the basis of individual merit without regard to race, color, national or ethnic origin, gender, gender identity, sexual orientation, marital status, veteran status, pregnancy, age, religion, disability, genetic information, or any other characteristic protected by law.

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