Director, Patient Access & Reimbursement

Join us as a Director, Patient Access & Reimbursement!

Join Abeona Therapeutics as a Director, Patient Access & Reimbursement and be a part of a mission-driven organization devoted to putting patients first. In this role, you will play a crucial part in ensuring that our cutting-edge health care solutions meet the highest quality standards. Collaborate with talented individuals dedicated to transforming lives through innovative therapies.

Work remotely Monday to Friday (some late or weekend work may be required) and contribute to impactful products that change peoples' lives. With a competitive salary of $200,000 - $230,000 per year (plus annual discretionary bonus and equity opportunities), this position not only offers financial rewards, but also the opportunity to build your career in a supportive, collaborative, and values-focused environment.

You will have options to participate in a comprehensive benefits program that includes options for Medical insurance to meet various individual/family needs, company covered basic Dental and Vision insurance (with additional coverage options), HSA and FSA options, a Lifestyle Spending Account, 401k options (with a company match program), and up to 160 hours of Paid Time Off per calendar year.

Abeona Therapeutics Inc.: Who We Are

Our Values: Patient First | Innovation | Integrity | Determination | Trust

Join us in making cure the new standard of care. At Abeona Therapeutics, we exist for our patients and their caregivers; their needs guide our decision-making. We challenge ourselves to think differently, move quickly, and deliver solutions. We hold ourselves to the highest ethical and quality standards. We persevere with resilience and focus to achieve our mission. We build trust through humility, mutual appreciation, openness, and respect.

Your day-to-day as a Director, Patient Access & Reimbursement

As a Director, Patient Access & Reimbursement at Abeona Therapeutics, your day-to-day activities will focus on contributing to company success by being the integral point of contact with our exclusive HUB service partner, payer access accounts, and centers of excellence to secure robust coverage and reimbursement for Abeona's therapies. This role is a critical, highly visible, customer-facing position providing reimbursement education expertise and support for customers (inclusive of payer accounts and centers of excellence) utilizing Pz-cell for the treatment of RDEB. Externally facing customers will include all levels at certified sites of care (SOC), our exclusive HUB partner, and Specialty Pharmacy.

The individual will work closely with HCPs, pharmacists, billing and coding staff and other professionals up to and including C-Suite level personnel involved in securing and resolving appropriate reimbursement for the use of Abeona's products. Additionally, the individual will interact with internal stakeholders including key account directors, patient services, patient operations and commercial leadership to support appropriate patient access to Abeona's current and future product portfolio.

The Director, Patient Access & Reimbursement, is expected to be a subject matter expert on all reimbursement processes (i.e., benefit verification, prior authorization, billing and coding, claim assistance, and appeals.) In addition, the individual needs to build and maintain strong relationships with health care provider practices and facilities, while implementing and managing all field reimbursement responsibilities. The role requires a high degree of verbal and written communication, account coordination, cross-functional collaboration and business acumen.

Your expertise will directly impact the quality and reliability of our therapeutic solutions, all while upholding our commitment to putting patients first. This position enables you to contribute meaningfully to the advancement of gene-based therapy solutions in a compliance-focused environment.

Schedule

The usual working hours for this role are Monday to Friday (some late or weekend work may be required) during daytime hours (start and end times may vary).

Does this sound like you?

To thrive as a Director, Patient Access & Reimbursement, the right combination of experience, education, skills, and attitude is essential.

The ideal candidate is an experienced market access and reimbursement leader with deep payer expertise and, ideally, rare disease or cell and gene therapy experience. Strategic, collaborative, and comfortable with extensive travel, you remove access barriers while living our values of Patient First, Innovation, Integrity, Determination, and Trust.

Essential Responsibilities and Duties

• Extensive travel requirements.
• Minimize reimbursement barriers for patients and providers and, therefore, optimize access to Abeona products, specifically Pz-cel.
• Ability to engage and consult with all Phase 1 sites of care (5-7) located throughout the United States.
• Contribute to the market access team's efforts with payer accounts: pre and post approval payer engagement.
• Support market access objectives of securing robust coverage and reimbursement through regional, national, and government payers.
• Identify, develop and manage strategic relationships with commercial and government payers.
• Present/provide approved product education and health economic information to key customers at payer, access, and treatment center accounts.
• Understand payer requirements and hospital reimbursement for cell/gene therapies administered in inpatient settings including implications for new novel therapies.
• Expected to work closely with HUB partner, Market Access & Key Account Directors in the field, supporting targeted institutions in resolving complex reimbursement cases.
• Experience launching rare disease products, cell and gene therapy preferred.
• Experience working with Pricing compendia databases.
• Reimbursement experience working with J Codes and Misc. J Codes.
• Staying current with Health policy changes and trends as they relate to reimbursement issues and/or challenges.
• Develop ethical and customer-oriented reimbursement strategies and proactively communicate payer criteria.
• The individual will serve as the primary lead for education, assistance, and issue resolution regarding reimbursement for Pz-cel.
• This position involves spending significant time (up to 50%) on-site with customers to assess their educational needs and facilitate collaboration with various stakeholders.
• You will be part of a dedicated team that values collaboration and education, allowing you to grow professionally while contributing to the well-being of patients.
• Track and monitor payer policies that will support appropriate case management strategies.
• Monitor and analyze situations impacting patient access to therapy.
• Collaborate with Market Access department and internal groups to resolve access issues.
• Serve as a subject matter expert on Medicare, Medicaid, and commercial plans and provide regular updates and insights to senior leadership on reimbursement trends, challenges and opportunities.
• Monitor and report on the effectiveness of reimbursement strategies and relevant information with the commercial team.
• Educating peers on Market Access elements, including reimbursement policies.
• Execute business in accordance with ethical and compliance standards.

Required Qualifications

• The knowledge and skills required to be successful in the role are:
• BS/BA in Business, Pharmacy, or Biologic Science preferred. Graduate degree is preferred but not required.
• 12+ years in the pharma/biotech industry.
• 10+ years combined complex reimbursement markets, payer relations, and market access strategy.
• Experience working within large geographic area (national).
• Experience in Rare Disease/Specialty products, gene and/or cell therapy preferred.
• Experience with payer stakeholders who manage medical policy and rare disease/gene therapy/cell therapy management.
• Working knowledge of total cost of care and all aspects of reimbursement for inpatient settings across payer segments.
• Demonstrated successful experience with national and regional payers in commercial, Medicaid, and Medicare.
• Proven leadership experience and capabilities.
• In-depth knowledge of current reimbursement trends, Buy and Bill, and Specialty Pharmacy/HUB services.
• Demonstrated initiative, creativity and strategic relationship building.
• Demonstrated ability to develop, communicate, and implement successful strategic initiatives.
• Demonstrated ability to thrive in a dynamic, fast-paced environment.
• Self-directed and confident, with developed ability to build teamwork centered on shared commitment and goals to achieve high standards of performance.
• Ability to successfully manage multiple tasks and multifunctional resources concurrently while maintaining high attention to detail while responding to rapidly changing priorities and aggressive deadlines.
• Proficient in MS Office (Word, Excel, Project), MS Teams, Qlickview, Adobe and raw data sets.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions. While performing the duties of this job, the employee is regularly required to experience prolonged sitting, some bending, stooping, and stretching. Hand-eye coordination and manual dexterity sufficient to operate a keyboard, photocopier, telephone, calculator, and other office equipment is required. A normal range of hearing and vision correctable to 20/20 is required. Occasional work in laboratory, cleanroom, or manufacturing environments may be required. Occasional lifting up to 25 pounds is required. May require wearing appropriate personal protective equipment (PPE) when entering GMP or lab areas. Occasional walking, standing, or climbing stairs within office or facility settings. Must be able to travel between company sites or to vendor locations, if needed.

Important Notes for Candidates:

Visa Sponsorship Not Currently Available

• Applicants must be authorized to work for ANY employer in the U.S. We are unable to sponsor or take over sponsorship of an employment Visa at this time.
• This is a career-path role that is not suitable for someone whose work authorization is temporary and based on optional practical training (OPT).
• Current or future H-1B sponsorship is not available for this role.

Additional Notes to Applicants:

• Due to the volume of applications received, we are unable to respond to every applicant. Only candidates whose qualifications most closely match the requirements of the position and who successfully complete the initial stages of the selection process will be contacted.
• All applications will be reviewed in accordance with applicable federal, state, and local employment laws.

EEOC Disclaimer

We're committed to building a workplace where everyone feels welcome. We are an equal opportunity employer and do not discriminate based on race, color, religion, sex, gender identity or expression, sexual orientation, age, disability, veteran status, or any other protected status.

Connect with our team today!

If you're ready to take your career to the next level and join a team that values hard work and changing lives - complete our application today!