Director, Reimbursement

Job Description As the environment for marketing biologic medicines has changed effective commercial strategies for large insurers, payers and provider systems have become more important. A larger, overall percentage will be influenced by innovative benefit designs and health plan-sponsored clinical guidelines. Commercial insurers, payers and government, as well as individual classes of trade within each will be important customers of the present and future brands of Biogen Idec. These entities will have significant impact on the way in which future therapies are delivered, paid for and consumed.The head, Reimbursement Operations is intended to provide leadership throughout the commercial operations of Biogen Idec in the area of planning and execution for public and private payer reimbursement. This role will direct the operations of the reimbursement team, which includes these divisions:CMS - Primary point of contact for all company relations and initiative with the agency itself.Provider Relations Head - Leader of a field team that implements reimbursement tactical support with providers.Reimbursement Strategy - These leaders support the SBU's in planning strategy and tactics for Medicare and Medicaid business and relations. This executive will also have an important role on the Managed Markets and Reimbursement Leadership team, which directs many of the commercial processes and strategies related to health care customers.
Reimbursement planning and execution:Support of Oncology and Neurology brand strategies in relation to public and private payers, which will represent a significant portion of the total business in 2006. Execution of strategy in CMS and with providers in collaboration with the field sales units, including National and Regional Account Management. Achievement of reimbursement tactical goals associated with provider relations. Direct contact with CMS and achievement of public reimbursement strategies and tactics with both Medicare and Medicaid,Targeted coverage and achievement of goals with Medicaid state agencies and carriers, as well as Medicare carriers.
Integration and collaboration with the Government Relations Team regarding issues of policy and reimbursement that cross functions.

Qualifications
A thorough understanding of the economics of health delivery and payment and its evolution, as well as an understanding of CMS policy and regulation developmen, the business models of public payer carriers and at-risk intermediaries. The candidate will also possess business and financial acumen at a high level with the skill to use this productively in lateral and superior relationships. Analytical and strategic skills at a high level are necessary in order to provide guidance to the organization regarding the application of market knowledge to the development of strategic direction. Finally, this candidate must understand the commercial processes that are critical to business performance, including brand plannig, POA timing and lead times, brand positioning and pricing strategy.Understanding of and support for compliance with OIG and regulatory requirements is a key element of leadership in this role.This person will posess professional certification (e.g., Pharm D, PhD), as well as 10 years experience in the industry including successful line management and commercial responsibilities. Alternatively, a non-industry-experienced candidate will have experience with CMS and hold an advanced business degree and some line management experience.

Education
This person will posess professional certification (e.g., Pharm D, PhD)