Director- US Reimbursement

BioSpace; King of Prussia (PA); Presencial; USD 160 000 - 230 000; Tempo integral

Resumo da oferta

CSL Behring seeks a Director, Reimbursement Strategy to translate market access and reimbursement plans into actionable field initiatives that optimize patient access and therapy adoption. The role partners across Market Access, FRMs, contracting, and policy teams to align payer policies with field execution.

The ideal candidate brings deep reimbursement expertise, strategic thinking, and proven cross-functional leadership in complex specialty markets to drive payer pull-through and access

Qualificações

• Bachelor's degree required.
• Advanced degree preferred (MBA/MHA/MPH/PharmD).
• Minimum of 10 years in pharma/biotech/market access.
• Minimum of 5 years in reimbursement or patient access.
• Experience with Medicare/Medicaid and specialty pharmacy reimbursement models.
• Experience with complex therapies (rare disease/biologic).

Responsabilidades

• Translate payer strategies into actionable reimbursement initiatives for field teams.
• Develop recommendations to address access challenges impacting patient access.
• Monitor payer policy changes and assess business impact.
• Collaborate with Market Access and payer-facing teams to support field pull-through.
• Identify systematic access barriers and scalable solutions.
• Lead cross-functional initiatives for new product launches and indications.

Conhecimentos

Market access

Reimbursement strategy

Cross-functional leadership

payer policy

Field reimbursement

Strategic planning

Data analytics

Stakeholder management

Communication

Problem solving

Formação académica

Bachelor's degree

MBA/MHA/MPH preferred

Healthcare/Pharma background

Ferramentas

Healthcare payer systems

CRMs/Market Access tools

Descrição da oferta de emprego

The Opportunity

The Director, Reimbursement Strategy, is responsible for driving the successful

The Director, Reimbursement Strategy, is responsible for driving the successful translation of market access and reimbursement strategy into field execution to optimize patient access and therapy adoption. Serving as a strategic leader supporting Executive Leadership and across Field Reimbursement Managers (FRMs), this role identifies reimbursement trends, access barriers, and payer challenges while developing scalable solutions that improve pull-through across provider accounts, health systems, specialty pharmacies, and payer channels.

The Director is a deep US reimbursement subject matter expert who partners extensively with Market Access, Patient Services, FRMs, Contracting, National Accounts, Trade, Specialty Pharmacy, Policy & Government Affairs, Medical Affairs, Legal, Compliance, and Commercial teams to ensure alignment between evolving payer policies and field execution.

This individual serves as a key conduit for reimbursement insights, helping shape reimbursement strategies that enhance provider experience, accelerate patient access, and support organizational objectives.

The ideal candidate combines deep reimbursement expertise with strong strategic thinking, cross-functional leadership, and a passion for improving patient access within complex specialty and rare disease environments.

The Role

Reimbursement Strategy & Market Access Execution

• Translate payer and market access strategies into actionable reimbursement and access initiatives for field teams and customers.
• Develop strategic recommendations to address reimbursement challenges impacting patient access and therapy initiation.
• Monitor changes in payer policy, utilization management criteria, reimbursement pathways, and healthcare regulations to assess business impact.
• Collaborate with Market Access and payer-facing teams to support field pull-through of coverage and access strategies.
• Identify opportunities to improve provider understanding of reimbursement requirements and access pathways.
• Support strategic planning for new product launches, indication expansions, and reimbursement initiatives.

Field Reimbursement Enablement

• Serve as a strategic partner to Field Reimbursement leadership and FRMs by providing guidance on reimbursement trends, emerging access challenges, and complex account situations.
• Identify systemic access barriers and develop scalable solutions that can be implemented across regions and customer segments.
• Support field excellence initiatives to elevate reimbursement knowledge base across field based teams.
• Facilitate consistency in reimbursement support approaches while maintaining compliance with company policies and industry regulations.
• Act as an escalation resource for complex reimbursement and access-related situations requiring cross-functional collaboration.

Payer Pull-Through & Customer Strategy

• Partner with market access and account teams to ensure payer coverage strategies are effectively translated into provider-level execution.
• Assess gaps between coverage policy intent and real-world implementation and recommend solutions to improve patient access.
• Support development of account-level reimbursement strategies for integrated delivery networks, specialty pharmacies, centers of excellence, academic institutions, and community-based providers.
• Analyze payer landscape trends and identify opportunities to improve access outcomes and customer experience.
• Collaborate on initiatives designed to reduce reimbursement friction and streamline patient access processes.

Cross-Functional Leadership

• Lead collaboration across Patient Services, Market Access, National Accounts, Trade, Specialty Pharmacy, Policy & Government Affairs, Medical Affairs, Commercial Operations, Sales, Legal, and Compliance teams.
• Ensure access-related insights from the field are incorporated into organizational strategy and decision-making.
• Influence stakeholders across multiple functions without direct authority to achieve business objectives.
• Participate in governance forums, strategic planning meetings, and cross-functional workstreams focused on patient access and reimbursement.

Analytics & Business Insights

• Analyze reimbursement, payer, and patient access data to identify trends, risks, and opportunities.
• Develop and communicate actionable insights to leadership regarding coverage dynamics, reimbursement performance, and emerging market trends.
• Establish and monitor key performance indicators related to access, reimbursement, and field effectiveness.
• Utilize customer feedback and field intelligence to continuously improve reimbursement strategies and support models.

Skills And Experience

• Bachelor's degree required.
• Advanced degree (MBA, MHA, MPH, PharmD, or related field) preferred.
• Minimum of 10 years of pharmaceutical, biotechnology, specialty pharmacy, healthcare, or market access experience.
• Minimum of 5 years of experience in reimbursement, patient access, field reimbursement, market access, or related functions.
• Demonstrated experience working with commercial, Medicare, Medicaid, and specialty pharmacy reimbursement models.
• Experience supporting specialty, rare disease, biologic, or complex therapeutic products preferred.

PACS Preferred

Prior leadership, coaching, or project management experience preferred.

Knowledge, Skills & Abilities

Advanced knowledge of reimbursement and patient access processes, including:

• Prior authorizations, Appeals, Reauthorizations.
• Benefit investigations, Specialty pharmacy distribution, Medicare and commercial coverage pathways, Payer policy implementation
• Strong understanding of:U.S. healthcare reimbursement environment, Market access strategy, Provider office workflows, Patient support services, Specialty therapeutic access models

Travel Requirements

Approximately 30-50% travel, including field visits, customer engagements, nationalmeetings, and cross-functional business meetings.

About CSL Behring

CSL Behring is a global biotherapeutics leader driven by our promise to save lives. Focused on serving patients' needs by using the latest technologies, we discover, develop and deliver innovative therapies for people living with conditions in the immunology, hematology, cardiovascular and metabolic, respiratory, and transplant therapeutic areas. We use three strategic scientific platforms of plasma fractionation, recombinant protein technology, and cell and gene therapy to support continued innovation and continually refine ways in which products can address unmet medical needs and help patients lead full lives.

CSL Behring operates one of the world’s largest plasma collection networks, CSL Plasma. Our parent company, CSL, headquartered in Melbourne, Australia, employs 32,000 people, and delivers its lifesaving therapies to people in more than 100 countries.

To learn more about CSL, CSL Behring, CSL Seqirus and CSL Vifor visit https://www.csl.com/ and CSL Plasma at https://www.cslplasma.com/.

Our Benefits

For more information on CSL benefits visit How CSL Supports Your Well-being | CSL.

You Belong at CSL

At CSL, Inclusion and Belonging is at the core of our mission and who we are. It fuels our innovation day in and day out. By celebrating our differences and creating a culture of curiosity and empathy, we are able to better understand and connect with our patients and donors, foster strong relationships with our stakeholders, and sustain a diverse workforce that will move our company and industry into the future.

To learn more about inclusion and belonging visit https://www.csl.com/careers/inclusion-and-belonging

Equal Opportunity Employer

CSL is an Equal Opportunity Employer. If you are an individual with a disability and need a reasonable accommodation for any part of the application process, please visit https://www.csl.com/accessibility-statement.