[Hiring] Payer Relations Director @Glaukos

Role Description

The Payer Relations Director (PRD) is a remote, home-based position responsible for the successful coverage and reimbursement as well as the overall management of coverage, coding, and reimbursement processes within an assigned region encompassing commercial insurance, MAC(s), and Medicaid.

• Establish favorable payer coverage and ensure fair and consistent payment.
• Remove barriers in the overall reimbursement process.
• Coordinate and execute reimbursement support for KOL healthcare providers.
• Partner with the Glaucoma Reimbursement Liaison Team and RL leadership team.
• Deliver consultations with KOL physicians and institutional customers.
• Interact with various customers including medical directors, MAC medical policy staff, and state government health staffers.
• Serve as an expert in payer policies to facilitate appropriate coverage and payment.
• Promote collaboration with Sales, Customer Relations, Reimbursement Liaisons, and Medical Affairs teams.
• Build relationships with key healthcare stakeholders for future technologies.
• Demonstrate teamwork abilities with high emotional intelligence.

Qualifications

• Bachelor's Degree required.
• Advanced degree or specific Practice Management experience.
• 15+ years of relevant industry experience.
• At least 10 years of Payer medical devices and biologics experience, ideally with injectable buy and bill drugs.
• Direct biologic launch experience highly desirable; Ophthalmology experience preferred.
• In-depth knowledge of the buy and bill system.
• 10+ years of reimbursement and account management experience preferred.
• Minimum 2 years of experience in practice management, billing and revenue cycle, or reimbursement interactions.
• Knowledge of private payer, Medicare, and Medicaid structure systems and reimbursement processes.
• Technical knowledge of healthcare reimbursement from a patient and provider perspective.
• Knowledge of reimbursement policies and hotline database systems.
• Ability to travel overnight for 3-4 nights per week; 50+% travel required.
• Strong communication skills; ability to effectively interact with all healthcare stakeholders.
• Ability to analyze and interpret regulation and legislation.
• In-depth knowledge of AdvaMed, MDMA, BIO, and PHARMA Guidelines.
• Project management skills and the ability to work independently.

Requirements

• Required outreach and networking with state/local KOL provider, patient, and healthcare systems advocacy organizations.

Benefits

• Generous.
• Innovative.
• Leadership-driven.
• Family-oriented.
• Socially responsible.

Company Description

Founded in 1998, Glaukos Corporation is an ophthalmic pharmaceutical and medical technology company focused on developing and commercializing novel therapies for the treatment of glaucoma, corneal disorders, and retinal diseases.

• Our mission is to transform vision by pioneering novel, dropless therapies.
• Innovation is at the core of everything we do.
• We are committed to challenging conventional thinking with new treatment alternatives.
• Our mantra “We’ll Go First” encapsulates our pursuit of game-changing technologies.
• Our company completed an initial public offering in June of 2015.
• Our shares are traded on the New York Stock Exchange under the ticker symbol “GKOS”.
• Global headquarters in Aliso Viejo, California with additional locations in San Clemente, California, and Burlington, Massachusetts.