Director of Market Access Payer

Harrow; United States; Remote; USD 120,000 - 180,000; Full time

Job summary

An innovative pharmaceutical company is seeking a Director of Payer Access to enhance market access for its diverse portfolio of ophthalmic products. This role involves strategic collaboration with sales and marketing teams to ensure optimal payer coverage and reimbursement processes. The ideal candidate will leverage their extensive experience in the pharmaceutical industry to implement effective business initiatives and monitor access metrics. Join a forward-thinking organization that values innovation and teamwork, and contribute to improving patient access to vital medications. This position offers the opportunity to make a significant impact in a dynamic and supportive environment.

Qualifications

• 12+ years of experience in pharmaceutical, biopharma, medical device, or healthcare.
• Proficiency in payer reimbursement processes and formulary control mechanisms.

Responsibilities

• Oversee formulary intelligence and payer access monitoring.
• Collaborate with sales and marketing teams for pull-through strategies.

Skills

Pharmaceutical Industry Experience

Market Access Strategy

Payer Reimbursement Knowledge

Contract Negotiation Skills

Problem-Solving Skills

Collaboration Skills

Education

Bachelor's Degree

MBA

Tools

Microsoft Word

Microsoft Excel

Microsoft PowerPoint

Job description

Before reading the job post, we encourage you to watch this video about our company. It gives you an inside look at how we started, the team and culture that made us successful, and where we're going. It's easy to read a job post and apply, but people often wonder about the culture and whether they would fit in. If you want to call Harrow your home and genuinely want to be part of a family and something big, then we encourage you to click this link and get to know us.

Who is Harrow?

Harrow (Nasdaq: HROW) is a leading North American ophthalmic-focused pharmaceutical company. Harrow is an incredible entrepreneurial company – where we celebrate the ability of every member of the Harrow Family to be the CEO of their job. Harrow’s values have driven interest over the past decade in attracting high-performing professionals in a variety of disciplines. Members of our Harrow Family often express their pride in being a part of our commitment to (1) innovation, (2) patient access to affordable medicines, and (3) our track record of having never turned down an ophthalmologist doing mission work around the world – providing free medicines in support of mission work aimed at giving or maintaining the gift of sight to those most in need. We encourage you to learn more about Harrow and its unique culture to see if you’re the right person to help contribute as we build a truly exceptional company, one we are all so proud of!

Harrow’s ophthalmic pharmaceutical portfolio is one of the most comprehensive in the industry, including:

• An expanding Posterior Portfolio including IHEEZO and TRIESENCE
• A broad Dry Eye Disease product line, led by VEVYE and bolstered by well-known adjacent ocular surface disease products such as FLAREX and TOBRADEX ST
• A Specialty Anterior Segment product line, which includes various high-need and utility products such as ILEVRO, NEVANAC, and VERKAZIA

Job Summary

The Director- Payer Access will support the VP of Market Access efforts to maximize profitable access for Harrow Eye's U.S. portfolio of promoted anterior and posterior products. The position is responsible for implementing short and long-term business initiatives established in collaboration with the VP of Market Access, as well at outside consultants, to ensure appropriate payer coverage and pull-through programs and opportunities. The position will also help support educational activities to ensure the field sales force understands the brand opportunities and placement of Harrow’s product(s) on targeted formularies and medical policies. These activities will also collaborate with Director - Market Access Strategy, and Harrow Marketing teams, for the development of pull-through programs and business review processes for sales management and field teams. Broad collaborator with sales leadership and field teams, Market Access partners, marketing, finance, legal, and operations.

Core Responsibilities

• Oversees formulary intelligence/payer access monitoring and tracks access within each of the pay types.
• Monitors access accuracy in all databases and cross references their content with internal assessment. Provides credible and timely access updates to Executive, Market Access and Sales leadership.
• Evaluates contract impact to business by working closely with Director- Market Access Strategy on net profit per product to best understand scope and limitations to contracting strategies
• Works closely with outside consultant to track performance metrics, payer strategy pull-through, bid and contract implementation and contract monitoring and adherence
• Engages in account portfolio planning using utilization data, payer mix, sales trends of each brand, and knowledge of therapeutic class management behavior by targeted plans, to determine prioritization of activities that will maximize profitability for Harrow Eye.
• Must have experience working with national (Emisar/Optum, Ascent/ESI and Zinc/CVS), regional, Medicare and Medicaid payers.
• Supports business plan creation for payer strategies that include clinical and economic elements to gain or maintain product access.
• Builds target account universe for KPIs and Objectives.
• Analyzes reports/real time sales data from Pharmacy/Hub/Patient Support Partners.
• Tracks progress and identifies ongoing issues or opportunities and makes suggestions for opportunities/improvement.
• Collaborates “proactive” communication to the Sales Teams with regards to access highlights, payer and pay mix opportunities.
  • Collaborates with field sales leadership in the development of their pull through plans.
• Monitors, reports on, and reinforces pull-through efforts to assure optimization of identified opportunities.
• Serves as a Payer subject matter expert to support all functional area partners by collaborating closely with stakeholders to ensure consistent exchange of important payer information and field messaging.
• Works with Market Access VP to oversee all strategic initiatives with contracting ROI.
  • Secures Harrow targeted rebate ranges and executes formulary wins with financial ROI.
  • Monitors payer bids and their overall accuracy for profitable access.
  • Conducts break even analyses for bids with assessment of bids versus status quo.
• Aligns with Director - Market Access Strategy on patient supports programs and assists specialty pharmacy partnerships for branded products.

Qualifications & Requirements

• Bachelor's Degree, MBA preferred
• 12+ years pharmaceutical, biopharma, medical device, or healthcare industry experience
• Market access payer experience required
• Anterior and/or Posterior Ocular/Eye experience preferred
• Demonstrated knowledge of payer reimbursement process for pharmacy and medical benefit drugs
• Proficiency in Word, Excel, and PowerPoint
• Experience creating and executing a pull-through plan for a pharmaceutical product because of a formulary event (change in coverage, advancement, replaced by another product) or medical policy even (restricted access, step edits, prior authorization policies)
• Understanding of formulary control mechanisms employed by MCO/PBMs and how they impact patients and physician's utilization
• Knowledge of US Payer coverage and reimbursement systems (Private and Government at the federal, state, and local levels), regulatory and medical policy changes, and pharmaceutical channel dynamics
• Pharmacy and Medical benefit formulary/policy experience as well as Medicare Part D and Part B exposure
• Proven history for securing and improving product coverage and reimbursement with or without contracting across commercial and government payers
• Able to manage multiple priorities simultaneously and communicate complex information clearly to others
• Demonstrated problem-solving, contract/bid review process experience, and negotiation skills
• Proven industry relationships
• Has a strong business acumen and a compliance mindset
• Strong collaborator - respectful and accountable

Position Type

• Remote

Travel

• 50-75%