Regional Director, Field Reimbursement, North Region

Regional Director, Field Reimbursement, North Region

Position Summary:

Reporting to the National Director of Reimbursement, the Regional Director, Field Reimbursement will be responsible for the development and implementation of the site of care reimbursement and patient access strategy for Apellis' Ophthalmology portfolio within their assigned region. This individual will and lead a team of 8 Field Reimbursement Managers responsible for supporting retina practices with patient access to Apellis' Ophthalmology products. This individual will use their experience and technical knowledge to help their team in identifying, understanding, and addressing reimbursement challenges that impact patient access to therapy obtained through both "buy and bill" and specialty pharmacy. As a member of the Field Leadership Team, the Regional Director, FRD will work with cross-functional partners (i.e., Marketing, Sales, Advocacy, Account Management, Patient Services, and Medical) to create and deploy solutions within their region that drive patient access, ensuring team alignment in overall execution of strategy.

Key Responsibilities Include:

Lead a field team:

• Develop (in conjunction with National Director) and provide clear direction to the Field Reimbursement Managers to ensure their daily activities are aligned with current Apellis strategies and maximize the value the team provides to Patients, Healthcare Provider's and Apellis.
• Foster a high-performance and forward-thinking culture in line with Apellis' values that places an emphasis on accountability, results, and collaboration.
• Ability to proactively anticipate and coach, mentor, train, and influence team members to ultimately enhance their ability to deploy Apellis resources in a strategic manner.
• Ensure FRM team has the required knowledge so Apellis FRMs are viewed among the most knowledgeable in the retina space. Identify areas of training to continue to elevate individual and team business acumen and competency within access and reimbursement landscape
• Monitor FRM adoption of HUB services and patient support programs at the practice level
• Monitor CMS and commercial insurer policies and keep abreast of trends in reimbursement and health policy that will affect Apellis products and marketplace.
• Require FRM team to have expert knowledge of coverage landscape within each aligned geography. (MAC, Medicare Advantage and Commercial plans).
• Establish and support local market diagnostics related to outlier payers and facilitate approach to ensure access equivalent to FDA label.
• Pull through national strategy at regional level to enable execution.
• Under the advisement of their manager, FRD will be responsible for leading specific national strategies and tactic development.
• Establish expectations for working in close collaboration with cross functional partners to facilitate ongoing feedback of team in support of shared accounts
• Drive the execution of quarterly business reviews at practices, both private equity and community based.
• Develop FRMs into future leaders, facilitating the pursuit of developmental opportunities and by providing ongoing coaching and feedback and specific outreach within the organization. Must be confident in performance management of FRMs to create a forward-thinking culture and drive business impact.

Collaboration with Cross-Functional partners:

• Work in lockstep with Reimbursement Marketing, Corporate Accounts, Sales and Patient Services to facilitate optimal access for patients to Apellis products.
• Provide feedback to Government Affairs/Public Policy and Account Management teams on engagement strategies and tactics regarding Medicare Administrative Contractors (MAC's).
• Provide insight in the development of marketing tools and resources necessary to support the FRM team discussions with practices to ensure they are educated on Apellis Assist offerings, access levels, and support of practice and patient portals in tangent with external vendors
• Maintain a national perspective in their decision-making, collaborate with their FRD peers, and lead projects/initiatives at a national and regional level (often self identified and self driven)
• In collaboration with Training, iterate on and execute a reimbursement learning & development plan as well as the educational content to build team members knowledge about product-specific coverage, coding and payment dynamics, Apellis support programs and other areas impacting patient and access to Apellis products.
• Training: Focus on areas of need identified in collaboration with FRD partners and customer feedback. Create content applicable to team, including but not limited to workshops, virtual trainings etc
• Interface and work cross-functionally with Commercial Excellence & Operations, Legal, Compliance, Sales, Marketing, Payer Account Management and Patient Advocacy.
• Ensure compliance with all corporate and industry policies in collaboration with Apellis Legal, Regulatory and Compliance.

Provide input to the strategic growth of the functional FRM team as well as the organization.

• Assist in the identification, creation and execution of strategic enhancements for the role in general. For example, establishing quarterly MBOs for team, training opportunities and strategic imperatives.
• Participate in the annual brand strategy and tactical plan from an access & reimbursement perspective.
• Understand cross-functional interdependencies within private equity owned practices, systems/institutions and sites of care, and their specific impact on strategy and execution
• Implement a process for best practice sharing across divisional teams to maximize effort

Education, Registration & Certification:

• Bachelor's degree required; MBA an advantage.

Experience:

• 12+ years of commercial experience in the pharmaceutical or biotech industry.
• 5+ years of experience in Healthcare Provider Reimbursement, Payer Relations or Account Management.
• 4+ years management experience demonstrating the ability to build and sustain high performing teams
• Ophthalmology experience strongly preferred.

Skills, Knowledge & Abilities:

• Deep knowledge of "buy and bill", Medicare Part B, medical benefit, and their associated reimbursement pathways. Deep understanding of healthcare ecosystems, reimbursement and account management approach.




• Technical expertise in ICD 10, HCPCS and cpt coding along with payer policy and reimbursement for in office administered products




• Ability to manage and influence in a highly matrixed environment.
• Experience in developing and directing the implementation of strategic, high-impact business plans.
• Breadth of experience in commercial, marketing, market access, trade, and patient services
• Exemplary presentation skills. Ability to clearly and succinctly convey ideas to key internal organizational stakeholders as well as specific decision makers in key accounts.
• A self-starter with the ability to prioritize needs, lead and drive results in an ambiguous environment.
• Strategic thinker. Understands the origin and reasoning behind key policies, practices, and procedures, as well as how and when to influence for change.
• Exceptional business acumen. Knows the competition; is aware of how strategies and tactics work in the marketplace.
• Advanced understanding of compliance with OIG & regulatory requirements.
• Ability to drive and lead through change.
• Proven record of leadership and development of people and teams.
• Passion for the patient journey and addressing patient needs.

Travel Requirements:

• Ability to travel up to 70% of the time.

Benefits and Perks:

Apellis offers a comprehensive benefits package, including a 401(k) plan with company match, inclusive family building benefits, flexible time off, summer and winter shutdowns, paid family leave, disability and life insurance, and more! Visithttps://apellis.com/careers/ to learn more.

Company Background:

Apellis Pharmaceuticals, Inc. is a global biopharmaceutical company that combines courageous science and compassion to develop life-changing therapies for some of the most challenging diseases patients face. We ushered in the first new class of complement medicine in 15 years and now have two approved medicines targeting C3. These include the first and only therapy for geographic atrophy, a leading cause of blindness around the world. With nearly a dozen clinical and pre-clinical programs underway, we believe we have only begun to unlock the potential of targeting C3 across many serious diseases.

For more information, please visithttp://apellis.comor follow us onTwitterandLinkedIn

EEO Statement:

Apellis is an equal opportunity employer and complies with all applicable federal, state and local fair employment practices laws. Apellis strictly prohibits and does not tolerate discrimination against employees, applicants or any other covered persons because of race, color, religion, creed, national origin or ancestry, ethnicity, sex (including pregnancy), gender (including gender nonconformity and status as a transgender or transsexual individual), age, physical or mental disability, citizenship, past, current or prospective service in the uniformed services, genetic information, marital status, AIDS/HIV status, smoker/nonsmoker, and occupational pneumoconiosis or any other characteristic protected under applicable federal, state or local law.

For San Francisco postings: Pursuant to the San Francisco Fair Chance Ordinance, we will consider for employment qualified applicants with arrest and conviction records.

Other Duties:

Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.