Senior Director, Field Reimbursement

Capricor Therapeutics; United States; Remote; USD 246.000 - 318.000; Vollzeit

Benefits dieser Stelle

Bonus potential

Equity incentives

Medical insurance

Dental insurance

Vision insurance

401(k) match

Paid time off

Parental leave

Zusammenfassung

Capricor Therapeutics is seeking a Senior Director, Field Reimbursement to build and lead the U.S. field reimbursement team as we prepare for deramiocel's launch for Duchenne muscular dystrophy.

You will design the field reimbursement model, hire and lead the Patient Engagement & Reimbursement Liaison team, and ensure timely, compliant support from benefits investigations through prior authorization and appeals.

Qualifikationen

• 10+ years biopharmaceutical experience with 5+ years in field reimbursement, patient access, or market access.
• 4+ years leading a field reimbursement or patient access team.
• Rare-disease or specialty launch experience required.
• Hands-on knowledge of medical-benefit reimbursement, buy-and-bill, specialty pharmacy, prior authorization, appeals, coding, and hub services.
• Strong working knowledge of HIPAA, OIG guidance, and the Anti-Kickback Statute as applied to field reimbursement and patient services.

Aufgaben

• Design the U.S. field reimbursement model for deramiocel, including territory alignment, team size, engagement rules, and launch sequencing.
• Build site-of-care readiness plans with treatment centers and infusion sites across buy-and-bill, specialty pharmacy, and medical-benefit pathways for an infused cell therapy.
• Translate payer coverage policies and coding guidance into field tools and training in partnership with Payer Strategy & Engagement.
• Partner with Trade & Patient Services to set the operating model between the field team and the hub vendor, including referral flow and escalation paths.
• Serve as the escalation point for complex benefits investigations, prior authorizations, denials, and appeals.

Kenntnisse

Field reimbursement leadership

Launch readiness

HIPAA & compliance

Payer policy translation

Vendor management

Cross-functional collaboration

Team building

Ausbildung

Bachelor's degree

MBA/MPH preferred

Jobbeschreibung

Capricor Therapeutics (NASDAQ: CAPR) is a biotechnology company dedicated to advancing transformative cell and exosome-based therapies for rare diseases. At the forefront of our innovation is Deramiocel(CAP-1002), our lead cell therapy in late-stage development for Duchenne muscular dystrophy. We are also harnessing our proprietary StealthX exosome platform to unlock new possibilities in targeted delivery and vaccinology. Every program reflects our commitment to pushing the boundaries of science and delivering life-changing treatments to patients and families who need them most.

The Senior Director, Field Reimbursement will build and lead Capricor's U.S. field reimbursement team in support of the anticipated launch of deramiocel, Capricor's lead cell therapy for Duchenne muscular dystrophy. The role is responsible for designing the field reimbursement model, hiring and leading the Patient Engagement & Reimbursement Liaison team, and making sure prescribers, treatment centers, and families get timely, compliant support from benefits investigation through prior authorization, appeals, and treatment. This leader partners closely with Trade & Patient Services, Payer Strategy & Engagement, the hub vendor, National Account Directors, Sales, Infusion Site Nurse Educators, Medical Affairs, Legal, and Compliance.

Key Responsibilities

Field Reimbursement Strategy & Model

• Design the U.S. field reimbursement model for deramiocel, including territory alignment, team size, engagement rules, and launch sequencing.
• Build site-of-care readiness plans with treatment centers and infusion sites across buy-and-bill, specialty pharmacy, and medical-benefit pathways for an infused cell therapy.
• Translate payer coverage policies and coding guidance, including HCPCS and ICD-10, into field tools and training in partnership with Payer Strategy & Engagement.

Hub, Patient Services & Case Escalation

• Partner with Trade & Patient Services to set the operating model between the field team and the hub vendor, including referral flow, case handoffs, and escalation paths.
• Serve as the escalation point for complex benefits investigations, prior authorizations, denials, and appeals.
• Hold the hub vendor and specialty pharmacy partners to agreed SOPs, service levels, and KPIs.

Account Education & Field Insights

• Lead the team's education of prescribers, treatment-center staff, and families on access pathways, support programs, and the treatment journey.
• Establish account plans, productivity measures, and field cadence for the Liaison team.
• Capture field insights on access friction, payer trends, and family experience, and report them to Market Access and Commercial leadership.

Operations & Compliance

• Own field reimbursement SOPs, documentation standards, CRM use, and the field reimbursement budget.
• Ensure all field reimbursement activity follows Capricor compliance standards, including FDA, OIG, PhRMA Code, HIPAA, and the firewall between patient services and promotional activities.
• Represent Capricor at key patient access and patient services conferences (e.g., Asembia).
• Perform other duties as assigned.

Required Qualifications

• Bachelor's degree required; advanced degree (MBA, MPH, or related) preferred.
• 10+ years of biopharmaceutical experience, including 5+ years in field reimbursement, patient access, or market access roles.
• 4+ years leading a field reimbursement or patient access team.
• Rare-disease or specialty launch experience required.
• Hands-on knowledge of medical-benefit reimbursement, buy-and-bill, specialty pharmacy, prior authorization, appeals, coding, and hub services.
• Strong working knowledge of HIPAA, OIG guidance, and the Anti-Kickback Statute as applied to field reimbursement and patient services.
• Demonstrated ability to build processes and teams in a launch or rapidly scaling environment.

Team Management

• Directly leads the Patient Engagement & Reimbursement Liaison team supporting the U.S. treatment-center footprint.
• Recruits, coaches, develops, and manages the performance of field reimbursement staff, including regular field time with each team member.
• Owns territory design, workload planning, training, and staffing to support launch readiness and post-launch scale.
• This team will expand as the business scales; the Senior Director will lead future hiring and organizational development.

Preferred Qualifications

• Cell or gene therapy field reimbursement or patient services experience.
• Neuromuscular, DMD, or pediatric rare-disease experience, including engagement with families and treatment centers.
• Experience standing up a field reimbursement team at launch.
• Established relationships with DMD treatment centers, infusion sites, and specialty pharmacies.
• Experience selecting and managing hub, specialty pharmacy, or field nurse vendors.

Core Competencies

• Strong problem-solving and decision-making ability.
• Vendor management and negotiation skills.
• Ability to work in a fast-paced, rapidly scaling environment.
• Exceptional attention to detail and documentation discipline.
• Ability to influence without authority across cross-functional teams.

Working Conditions

• Field-based (remote) position; expected to be in the San Diego, CA office approximately two to three times per quarter, or as required by business need.
• Domestic travel approximately 50 to 60% for field coaching, treatment-center engagement, conferences, and internal meetings.
• Extended periods of computer-based work, including video conferencing and collaborative software platforms.

$246,420 - $317,850 a year

Compensation and Benefits

The posted salary range represents Capricor’s good-faith estimate of the salary range reasonably expected to be paid for this position at the time of hire. Final compensation will be determined based on job-related factors, including the candidate’s relevant experience, education, skills, certifications, scope of role, location, and internal equity.

This position may also be eligible for a discretionary annual performance bonus and, depending on the level of the role, long-term equity incentive awards in accordance with company policy.

Capricor Therapeutics offers a comprehensive benefits package that includes employer-sponsored medical, dental, and vision coverage; company-paid basic life and AD&D insurance; a 401(k) plan with company match; paid time off and company holidays; and paid parental leave. Additional voluntary benefits and wellness programs may also be available.

Why Capricor?

Capricor Therapeutics is advancing cell and exosome-based therapies with a focus on serious diseases where patients and families need new treatment options. Our work is grounded in scientific rigor, collaboration, and a shared commitment to moving meaningful therapies forward. Joining Capricor means being part of a mission-driven team working at the intersection of innovation, execution, and patient impact.

Come Work With Us

At Capricor, you’ll join a collaborative environment where employees are encouraged to contribute, grow, and help build the systems, science, and operations needed to support our next stage of growth. We value people who are thoughtful, accountable, hands-on, and motivated by work that can make a real difference.