Senior Director, Value, Pricing & Reimbursement (Redwood City)
Rezolute, Inc.
Job Description
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Rezolute is a late-stage rare disease company focused on significantly improving outcomes for individuals with hypoglycemia caused by hyperinsulinism (HI). Our antibody therapy, RZ358 (ersodetug), is designed to treat all forms of HI and has shown substantial benefit in clinical trials and real-world use for the treatment of congenital hyperinsulinism (cHI) and tumor hyperinsulinism (tHI).
We are seeking a highly skilled and experienced Senior Director, Value, Pricing & Reimbursement, to serve as key member of the Value, Access & Patient Services team, responsible for providing Global market access leadership and competencies in support of the Rezolute pipeline. She / He will be responsible for providing strategic market access value and pricing input into the evolving pipeline and will lead, shape, and coordinate the development of evidence-driven value solutions, reimbursement strategies, tools, and resources with the goal of achieving optimal market access for Rezolute products.
Essential functions will include cross-functional engagement, alignment, education and partnership with key internal company stakeholders and external vendors, with an emphasis on ensuring seamless patient and provider access to Rezolute’s product portfolio. The Senior Director will be responsible for constructing the market access value platform and supporting materials to ensure product differentiation, coding, coverage policy and formulary positioning. The role will work closely with Regulatory, Clinical and Medical Affairs ensure that clinical trials support above country clinical and economic outcomes necessary to support labelled HTA Pricing and Reimbursement + Coding (ICD-10 + J-code) strategies / submissions, and unnecessary US payer coverage utilization management controls.
It is critical that the Senior Director has past US Payer, Organized customer, and/or HEOR experience, and can drive innovative initiatives around US Market Access strategy, public policy, product outpatient, pricing, contracting, process, programs, executive level presentation support and potential payer and organized customer engagement models and tools.
Although the position can be remote, this leader will be required to interface regularly with the Rezolute Market Access and Reimbursement, Sales, Medical Affairs, and Clinical Development teams.
Essential Duties And Responsibilities
- Provide critical leadership and above-country market access strategies including core disease models, value stories, global pricing, economic modeling, and input into Clinical Development programs.
- Work closely with Medical Affairs colleagues, Organized customers and Distribution providers to identify real-world and patient quality of life data capture / evidence value solutions and publication opportunities.
- Monitors healthcare legislative trends, understands healthcare policies, assesses implications of policies, and develops reimbursement strategies that address barriers to provider and patient access.
- Understands total cost of care and all aspects of reimbursement (coverage, coding, and payment) for outpatient and inpatient settings across multiple payer segments.
- Support the formulation of a clear and compelling disease and product value propositions through the creation of payer engagement (AMCP Dossier, Value and Economic Prop.), and provider / patient reimbursement support tools.
- Monitor the competition to understand how the evolving market will impact current and future market access strategies.
- Identify and develop pricing recommendations, coding and reimbursement strategies for current and pipeline assets that will support future Pricing and Reimbursement decisions in the US and other key Ex-US markets.
- Engage to support the advancement of ICD-10 CM coding initiatives, and product-specific HCPCS coding application.
- Identify product market access risks and opportunities, incorporate them into pipeline product strategies and reflect them in identified Target Product Profiles.
- Identify pricing and reimbursement analogues to support value and access decisions.
- Create payer materials for branded and unbranded disease awareness campaigns.
- Support the identification, creation of defensible, performance driven, quality / outcomes or risked based product / portfolio contract, or rebate opportunities.
- Manage agency relationships and contracts to deliver tools/tactics/resources, and ensure on time delivery, that is aligned with the departmental budget.
- Provide subject matter expertise to the broader organization, including competitive and product coverage access intelligence, healthcare reform, landscape trends, and pull-through initiatives. This includes cross-functional support of corp. training initiatives, content, tools and presentation development in partnership with Training and Cross-Departmental leaders.
- Represent Rezolute at Key Industry Conferences (e.g. AMCP, PCMA, ISPOR, Asembia, etc.).
The Senior Director will report to the VP, Value, Access & Patient Services, and needs to collaborate effectively with all internal departments.
Preferred Experience, Education, Certifications, Licenses
- Minimum Bachelor’s degree required; sciences or business preferred, advanced degree related medical, health economics, health outcomes research, or epidemiology (MS, MBA, MPH, MD/DO, PhD, PharmD) preferred.
- Minimum of 10 years of overall industry experience in biotech or pharmaceuticals (i.e. market access and reimbursement, sales, sales management, marketing, training, sales operations, or healthcare / life sciences consulting).
- 5 years of US market access and reimbursement experience required, with Global and/or international experience preferred. This includes, HTA, US Payer, Patient and Provider access, HEOR, and medical benefit reimbursement coding expertise.
- Experience with rare/orphan drugs is required. Therapeutic area experience is a plus.
- Product launch experience is required, and company start-up experience is preferred.
- Familiarity with current legal and regulatory landscape pertinent to the pharmaceutical/biotechnology industry.
- Strong analytical capabilities, with working knowledge of government pricing practices (calculations methodologies, HTA, healthcare programs, and supporting regulations), and trade systems and processes.
- Demonstrated flexibility to adapt to a changing environment, implement creative solutions to complex problems, and ability to function in a project leadership role.
- Ability to develop and maintain strong internal and external relationships, including direct collaboration with vendors and other third parties.
- Superior interpersonal, oral and written communication, and presentation skills, with great attention to detail.
- Leads with strong business acumen and a compliance mindset.
- Passionate about patients and building a new commercial organization.
- Advanced Microsoft Excel, Word and PowerPoint skills.
- No supervisory responsibility, but supports to recruit, interviews, hires, and trains new staff.
- Provides constructive and timely performance feedback and evaluations.
- Other related supervisory responsibilities as assigned.
- This position a field-based (remote) position, but is expected to be in the Redwood City, CA office approximately 2 – 3 times per quarter, or other frequency as required by business necessity or as reasonably required by the position’s manager.
- Domestic travel will be required up to 30 – 50%, based upon business needs.
Qualifying employees are eligible to participate in benefit programs such as:
- Health Insurance (Medical / Dental / Vision)
- Disability, Life & Long-Term Care Insurance
- Holiday Pay
- Tracking Free Vacation Program
- 401(k) Plan Match
- Educational Assistance Benefit
- Fitness Center Reimbursement
Seniority level
Rezolute, Inc.
Redwood City, CA