Director, Payer Access & Reimbursement

Director, Payer Access & Reimbursement

• Company: Gamida Cell, Inc.
• Posting Title: Director, Payer Access & Reimbursement
• Function: Commercial
• Location: Remote

Gamida Cell is a leader in advanced cellular therapies and hematopoietic stem cell transplantation, with two FDA approved therapies, Omisirge® (omidubicel-onlv) and APHEXDA® (motixafortide). Omisirge® is a nicotinamide (NAM) modified allogeneic hematopoietic progenitor cell therapy that is potentially curative for patients with hematologic malignancies. APHEXDA® is a CXCR4 antagonist with long receptor occupancy indicated in combination with filgrastim to mobilize hematopoietic stem cells to the peripheral blood for collection and subsequent autologous transplantation in patients with multiple myeloma.

General Scope and Summary

The Director, Payer Access & Reimbursement plays an important role in securing timely access to therapies for patients and will collaborate cross functionally with the medical affairs, account management, and cell therapy operations teams to support transplant centers. The core function of the role is to operationalize the overall payer and hospital administrator strategy. The Director, Payer Access & Reimbursement will ensure that hospital administrators are educated on appropriately accessing Gamida Cell’s therapies and on relevant coverage and reimbursement policies.

The Director, Payer Access & Reimbursement will report to Sr Director, Payer Access & Reimbursement.

Roles and Responsibilities

• Obtain positive coverage for Gamida Cell products with national and regional payers within assigned region

• Educate hospital administrators (C- suite level, billing and reimbursement personnel, chargemaster personnel) on appropriate formulary, access, coverage and coding requirements for Gamida Cell products to build reimbursement confidence

• Build proactive relationships with organizations/KOLs whose experience and expertise are relied on by payers
• Assess payer and state policy landscape to understand potential impact to coverage of Gamida Cell’s products for Commercial, Medicare and Medicaid patients
• Develop and implement payer account level business plans and contribute to overall hospital account business plans
• Responsible and accountable for the successful implementation within region of the strategic and tactical market access plan
• Present / provide approved product education and health economic information to key customers and communicate the value proposition of Gamida Cell’s products
• Partner with Medical Affairs to address clinical and outcomes concerns from payers and formulary decision makers
• Obtain coverage for Gamida Cell’s products within assigned accounts
• Identify and mitigate potential challenges that may hinder access
• Work with Gamida Cell Assist to ensure understanding of payer coverage policy and requirements and assist with any coverage questions
• Establish critical relationships with a variety of stakeholders within their geography: key transplant centers, Medicare CMDs, health plan medical directors and state Medicaid directors

Experience, Education and Specialized Knowledge and Skills

• Demonstrated successful experience with National and Regional payers (5-7 years minimum); 10+ years total biotech/pharmaceutical experience in a commercial setting.
• Sustained track record of access and reimbursement achievement in cell therapy, gene therapy, or hematology/oncology
• Knowledge of medical benefit, inpatient, transplant and/or cell and gene therapy economics preferred.
• Excellent strategic and business acumen skills, with demonstrated ability to successfully partner with payers.
• Strong ability to work collaboratively and cross-functionally to ensure goals are achieved.
• Possess a willingness and ability to work hands-on and with a sense of urgency, in a fast-paced, entrepreneurial environment.
• Outstanding written and verbal communication skills with the ability to effectively present to and engage with a wide range of audiences.

• Proven ability to think strategically and prioritize.
• Exceptional problem-solving skills.
• Exhibits initiative, flexibility, tenacity, and dependability.
• A./B.S. degree required; Master’s Degree a plus but not required.

Travel: 50% travel

Reports to: Sr Director, Payer Access and Reimbursement

Gamida Cell considers a range of factors when determining base compensation and therefore the final compensation will vary depending on experience level.