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Optimizes access to the full Alnylam portfolio of products by ensuring that provider accounts understand access and reimbursement dynamics
Proactively identifies trends impacting barriers to access or reimbursement and creates solutions
Works with internal stakeholders and providers to support treatment pathways for patients
Proactively engages with key stakeholders in accounts, including Intake/Authorization teams, billing compliance, Finance executives (Revenue Cycle, Revenue Integrity), Infusion Center management and decision-makers and key Pharmacy Stakeholders
Responsible for identifying, addressing and resolving outstanding claim payment issues
Provides guidance to case managers on case-specific complex PA/Appeal issues
Collaborates with case managers on treatment site finding for the specialty business when there are no site of care options available in the treatment directory
Provides case-specific PA/Appeal support and site of care options for the rare business
Maintains relationships with Medicare Administrative Contractors (MACs) to optimize coverage for Alnylam therapies and monitors Local Coverage Determinations (LCDs) and National Coverage Determinations (NCDs)
Works with Public Policy & Government Relations team on engagement strategies and tactics regarding MACs or local policy changes as well as state-level public policy initiatives
Utilizes reporting dashboards to track critical metrics and key performance indicators (KPIs)
Ensures compliance with all corporate and industry policies in collaboration with Alnylam Legal, Regulatory and Compliance
Field Reimbursement Director - Northern California
Cambridge, MAPosted Yesterday