Avalere is a global strategic healthcare advisory firm responsible for evaluating how our clients’ assets fit within the emerging coverage and reimbursement landscape and optimizing market access for their products through deep subject matter expertise and understanding of their business issues. The Market Access team focuses on a wide range of areas: coverage, coding, and payment across commercial and public payers; pricing and contracting; distributors and specialty pharmacies; field team design and deployment; and patient support services.

Avalere continues to grow its capabilities focused on providing strategic market access and policy guidance to manufacturers, foundations, and third-party entities related to patient access, affordability, and broader support services. Avalere leverages its experience and deep expertise to support the design, development, and implementation of patient support services and field-based reimbursement teams.

Responsibilities

• Lead cross-functional project teams to solve complex client problems in the patient support services and broader market access space and engage clients with novel solutions and ideas related to market access and patient affordability strategy, public policy and market trends, commercialization challenges, and operational considerations
• Serve as a subject matter expert on patient support-related market access issues, including hub program design, patient access (e.g., patient journey experience, site of care, clinical and non-clinical patient risk factors such as social determinants of health),  patient affordability (e.g., copay assistance, copay accumulators and maximizers, free drug/foundation support, specialty pharmacy support), reimbursement support, and field-team support initiatives
• Manage multiple mid-to-large patient services projects and other market access projects for clients, assembling cross-functional practice teams from project initiation through project delivery, including ability to communicate and respond to project performance relative client feedback and expectations
• Monitor policy developments to ensure that Avalere clients are well informed and appropriately prepared for the evolving government oversight, regulatory environment, legal, and reputational landscape surrounding manufacturer-sponsored patient support programs
• Drive the development of both strategic and tactical patient support strategy recommendations for clients to ensure optimal market access for client products
• Solve complex client issues in a timely and appropriate manner with minimal management oversight and attention to resources
• Work with subject matter experts, technical staff, vendors/partners, client teams, and others within Avalere to ensure the operational and financial success of projects and programs under management
• Manage multiple clients and short- and long-term deliverables to ensure Avalere’s vast knowledge and expertise are available to meet client needs
• Assist in the evaluation and analysis of Avalere/Fishawack Health proprietary data and public data sources to identify payment/care utilization trends in the patient access and support services and inform public and client-facing insights
• Assist in the development and review of scopes of work, budgets, timelines, and other business documents to drive and generate new business opportunities in the patient support services space
• Mentor, supervise, and train staff members within the Market Access Practice and across the firm
• Develop and maintain a professional level of knowledge regarding Avalere’s and Fishawack Health’s services and products
• Maintain compliance with Fishawack Health’s policies, procedures, and mission statement
• Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function

• Bachelor’s degree in health policy, public policy, healthcare management, public health, public administration, health economics, business administration, law, health sciences, or a relevant discipline

Subject matter expertise should reflect an expert-level understanding of the following:

• Hub program services, design, evaluation, and implementation
• Manufacturer copay assistance trends and strategies
• Key performance indicators, service level agreements, and business rule development and implementation for patient support program, field reimbursement teams, and patient service vendors
• Understand intricacies of the US healthcare payment system, including the outpatient prospective payment system and inpatient prospective payment system, bundled payment system, including considerations around facility and provider payment, facility- and patient-level payment adjustments, and payment pathways for new drugs, equipment, and supplies
• Public payer and commercial plan coverage, utilization management, and payment considerations for drugs, biologics, and diagnostics
• Patient population characteristics and challenges that drive access challenges and disparities in care options and outcomes
• Dynamics of manufacturer channel and patient access support services, business-to-business relationships, and how they impact care delivery with providers and patients
• Role that the mandatory and voluntary CMMI models play in informing payment and care decision making

Skill Requirements

• Superior attention to detail and the ability to analyze complex problems
• Proven ability to initiate and drive projects through to completion
• Excellent communication, presentation, and time management skills are required; must be adaptable, flexible, and able to work well within a team and relate effectively with people at all levels of the organization, including senior leadership
• Ability to build trust and cultivate relationships with diverse internal and external stakeholders
• Problem definition and resolution skills
• Demonstrated ability to manage multiple project teams in parallel
• Demonstrated leadership in ambiguous situations
• Ability to analyze data to drive decision-making
• Able to effectively manage competing priorities with a strong sense of urgency
• Ability to think creatively, striving for solutions to access issues

• 5–8 years of experience working in reimbursement, pharmaceutical manufacturing, or patient support services; examples of relevant work experience include pharmaceutical manufacturers (preferably in a patient access/support or field-based reimbursement support role), patient services vendors, consulting firms, and the healthcare industry at large.
• At least 2 years of supervisory experience; experience supervising and leading teams remotely preferred.