REIMBURSEMENT LIAISON DIRECTOR
The Reimbursement Liaison Director’s primary role is to facilitate the growth of Glaukos products by way of leading and coaching field-based reimbursement team members. Work cross-functionally with the internal Director of Sales, Director of Corporate Accounts and Private Equity, Payer Relations team and Payer Strategy team to ensure a unified platform.
What will you do?
The Reimbursement Liaison Director provides strategic leadership and expert guidance to a team of field-based Reimbursement Liaisons. This role’s focus is on facilitating patient access to Glaukos’ sight-saving technologies through comprehensive coding, coverage and payment education and support for healthcare providers (HCPs). The Reimbursement Liaison Director collaborates cross-functionally with numerous departments including Sales, Corporate Accounts, Practice Integration, Patient Services/HUB, Payer Relations and Payer Strategy to ensure a unified and effective approach to patient access.
Responsibilities include:
- Leads and mentors by establishing clear objectives and performance metrics, including providing tactical guidance on complex reimbursement issues and ensuring the team has the necessary resources to meet customer needs.
- Establish team SOPs, KPIs, Development opportunities and oversee a structured performance management framework, including regular evaluations and feedback sessions.
- Identify training needs and coordinate development opportunities to enhance team performance and expertise in reimbursement practices while fostering a culture of continuous improvement and accountability.
- Ensure all reimbursement activities comply with legal, regulatory, and corporate guidelines, mitigating risks associated with non-compliance
- Establish, monitor, report customer engagement, outcomes, and RL SOPs metrics.
- Lead Performance Reviews, including ride-alongs/co-travel to provide expertise and coaching: in account management, specialty pharmacy, patient assistance programs, buy & bill acquisition, policy reviews, claim reviews and processing.
- Proactively scanning/monitoring, identifying, and reporting reimbursement trends with strong personal ownership for identifying and communicating solutions via cross-functional collaboration (e.g., HCPs receiving notification of policy changes, claim denials, underpayments, etc.) and engages payer team appropriately when patient access may be jeopardized.
- Maintain expertise in regional and national payer landscapes, specifically, proper clinical requirements, reimbursement policy, utilization management criteria, prior authorization processes and appeal requirements.
- Ability to travel adequately to cover territory, as well as overnight travel (~50%) and attendance at scheduled training and meetings.
How Will You Get Here?
Required
- Bachelor’s Degree in Science, Business, or Marketing required. Advanced Degree (MPH, MBA ,MHA) preferred.
- Minimum of 10 years “direct” reimbursement/healthcare policy experience.
- Minimum of 3-5+ years previous field-based reimbursement team management experience, preferably with products within prelaunch or early launch phases.
- Experience with launching and supporting drug/ device combination products.
- Demonstrated subject matter expertise in US Payer/insurance coverage and marketplace, including Medicare, Medicare Advantage, VA/Tri-Care, Commercial and Medicaid.
- Cross-functional experience and strong interpersonal skills within a team environment, with experience leading by influence towards business result.
- Demonstrated excellent proven written and verbal communication skills with ability to speak to all levels of the organization as well as understand and use data in communications.
Preferred
- Previous ophthalmology product/services in ASC/MD office experience.
- Cross-functional team experience in multiple drug/device combination departments, such as business development, strategy, marketing, sales and/or corporate development roles within a medical device or pharmaceutical company.
- Experience working in a highly matrixed environment that incorporates compliance with all corporate, regulatory and legal guidelines.
