Associate Director, Field Reimbursement

Alnylam Pharmaceuticals, Inc.; Madison (MN); On-site; USD 174,000 - 236,000; Full time

Job summary

Alnylam Pharmaceuticals seeks an Associate Director, Field Reimbursement to optimize patient access across the Great Lakes North region (MN/ND/SD/IA/WI). You will lead reimbursement strategies, educate sites of care, and collaborate with cross-functional teams to resolve access challenges and ensure timely treatment for patients.

The role requires deep payer landscape knowledge, strong relationship skills with MACs and providers, and willingness to travel up to 50%.

Qualifications

• Bachelor’s degree required.
• 5+ years pharma/biotech or other healthcare experience.
• 3+ years field reimbursement in buy and bill for rare disease, oncology, specialty products or infusions.
• Established relationships with Medicare Administrative Contractors (MACs) preferred.
• Strong knowledge of the US payer landscape across medical and pharmacy benefits.
• Willingness to travel up to 50%.
• Residence within geography or within 75 miles of a mid-size or larger airport.

Responsibilities

• Optimizes access to the full Alnylam portfolio by ensuring provider accounts understand access and reimbursement dynamics.
• Identifies trends impacting barriers to access or reimbursement and creates solutions.
• Works with internal stakeholders and providers to support treatment pathways for patients.
• Engages with key stakeholders in accounts— Intake/Authorization, billing, revenue cycle, infusion center management, and payers.
• Addresses and supports education to resolve outstanding claim payment issues.
• Mentors case managers and field reimbursement team on PA/Appeal issues.
• Provides site-of-care options for rare business and PA/Appeal support.
• Maintains relationships with MACs and monitors LCDs/NCDs.
• Collaborates with Policy & Government Relations on MAC strategies and state policy initiatives.
• Uses dashboards to track KPIs and ensure compliance with policies.

Skills

Payer landscape expertise

Stakeholder relationships

Strategic planning

Cross-functional collaboration

Excellent communication

Education

Bachelor’s degree

Job description

Overview

Reporting to the Field Reimbursement Director, Lead, the Associate Director, Field Reimbursement will optimize access to Alnylam products in his/her region by understanding and addressing reimbursement and patient access challenges. This position requires a professional who can leverage his/her technical expertise and experience to deliver educational, reimbursement in-service programs to all sites of care (Medical Doctors Office, Alternative Infusion Centers, Hospital Outpatient Department, etc.) and manage access and reimbursement issues by initiating as well as leading action plans to resolve these issues.

Overview

Reporting to the Field Reimbursement Director, Lead, the Associate Director, Field Reimbursement will optimize access to Alnylam products in his/her region by understanding and addressing reimbursement and patient access challenges. This position requires a professional who can leverage his/her technical expertise and experience to deliver educational, reimbursement in-service programs to all sites of care (Medical Doctors Office, Alternative Infusion Centers, Hospital Outpatient Department, etc.) and manage access and reimbursement issues by initiating as well as leading action plans to resolve these issues.

A key component of this role is the ability to establish and deepen customer relationships through quality interactions with access and reimbursement focused external stakeholders at targeted strategic accounts. As such, extensive knowledge of ‘buy and bill’ products and prior experience with high-touch, specialty products are essential.

The Field Reimbursement Team is a critical part of the commercial strategy, working closely with National Account Leads (NALs), Health Systems Directors (HSDs), Regional Account Leads (RALs), Site of Care Directors, Patient Services, the broader Reimbursement team, and Sales to support Alnylam’s patient-focused vision of harnessing a revolution in biology for human health.

The successful candidate must be passionate about science and deeply motivated by the quest of delivering value to patients with the long-term success of the company in mind. He/she will work collaboratively with both internal and external stakeholders to build tactical plans to execute strategic imperatives.

The Great Lakes North territory encompasses North Dakota, South Dakota, Minnesota, Iowa, and Wisconsin.

Key Responsibilities

• Optimizes access to the full Alnylam portfolio of products by ensuring that provider accounts understand access and reimbursement dynamics
• Proactively identifies trends impacting barriers to access or reimbursement and creates solutions
• Works with internal stakeholders and providers to support treatment pathways for patients
• Proactively engages with key stakeholders in accounts, including Intake/Authorization teams, billing compliance, Finance executives (Revenue Cycle, Revenue Integrity), Infusion Center management and decision-makers and key Pharmacy Stakeholders
• Responsible for identifying, addressing and supporting education to resolve outstanding claim payment issues
• Provides mentorship and guidance to case managers and field reimbursement managers on case-specific complex PA/Appeal issues
• Provides case-specific PA/Appeal support and site of care options for the rare business
• Maintains relationships with Medicare Administrative Contractors (MACs) to optimize coverage for Alnylam therapies and monitors Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs)
• Works with Public Policy & Government Relations team on engagement strategies and tactics regarding MACs or local policy changes as well as state-level public policy initiatives
• Utilizes reporting dashboards to track critical metrics and key performance indicators (KPIs)
• Ensures compliance with all corporate and industry policies in collaboration with Alnylam Legal, Regulatory and Compliance

Qualifications

• Bachelor’s degree required
• 5+ years prior pharma/biotech or other related and relevant healthcare experience
• 3+ years of field reimbursement experience in “buy and bill” preferably in rare disease, oncology, specialty products and/or infusions/injectables
• Established relationships with Medicare Administrative Contractors (MACs) highly preferred
• Strong knowledge of the US payer landscape
• Deep understanding of both medical benefit and pharmacy benefit across payer types (Medicare, Medicaid, commercial, VA/DoD, etc.) and sites of care (Hospital Outpatient Department, free standing centers and home infusion)
• Proven ability to identify key access and reimbursement barriers to treatment and design effective resolution plans
• Exceptional professional communication, interpersonal and problem-solving skills necessary to interact with decision makers (CFO and other C-suite level stakeholders)
• Demonstrated ability to lead without authority in a highly collaborative matrix and fast-paced environment
• Self-starter who is enthusiastic about rare disease and Alnylam’s core values: fiercely innovative, open culture, purposeful urgency, passion for excellence, and commitment to people
• Ability to travel up to 50%
• Must reside in geography or within 75 miles of the boundary and with reasonable proximity to a mid-size or larger airport

About Alnylam

We are the leader in RNAi therapeutics– a revolutionaryapproach with the potential to transform the lives of people with rare and common diseases. Built on Nobel Prize-winning science, Alnylam has delivered the breakthroughs that made RNAi therapeutics possibleand are just at the beginning of what’s possible. Our deep pipeline, late-stage programs, and bold vision reflect our core values: fierce innovation, passion for excellence, purposeful urgency, open culture and commitment to people. We're proud to be a globally recognized top employer, wherean authentic, inclusive culture and breakthrough thinkingfuel one another.

At Alnylam, we commit to an inclusive recruitment process and equal employment opportunity. Qualified applicants will receive consideration for employment without regard to their sex, gender or gender identity, sexual orientation, race, color, ethnicity, national origin, ancestry, citizenship, religion, creed, physical or mental disability, pregnancy status or related conditions, genetic information, veteran or military status, marital or familial status, political affiliation, age, or any other factor protected by federal, state, or local law. Alnylam is an E-Verify Employer.

Before applying, please review Alnylam's Candidate Privacy Notice regarding how Alnylam handles Personal Data you provide with your application for employment.

Learn more about these and additional benefits offered by Alnylam by visiting the Benefits section of the Careers website: https://www.alnylam.com/careers. U.S. Pay Range: $174,300 - $235,700 USD.