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Director, Policy and Reimbursement

Employer
GlaxoSmithKline
Location
Washington, DC
Closing date
Aug 17, 2022
Site Name: USA - District of Columbia - Washington Dc, Philadelphia Walnut Street, RTP, Waltham Posted Date: May 24 2022 The Director, Policy and Reimbursement will lead and manage GSK US reimbursement activities. This individual will be responsible for the coordination, completion and filing for all relevant coding applications with required organizations including CMS, CDC & AMA and will lead policy analysis, policy development, and internal and external thought leadership on key issues surrounding therapy access including Medicare Part A & B, Medicaid and 340B. They will work across the Government Affairs and Public Policy (GAPP) team and the commercial team to drive GSK and ViiV's reimbursement goals. The position interacts with internal and external stakeholders to strategically analyze impact of access and payment policies proposed by government and to support and develop GSKs reimbursement policy positions. Internally, this includes GSK US Commercial Business Units, GSK US Legal, GSK US Market Access team, GSK Global teams, and ViiV Healthcare. Additionally, this position will work closely with the entire Government Affairs and Public Policy (GAPP) team by being an internal reimbursement expert advising on reimbursement policy proposals that may affect GSK and ViiV products. Externally, this position engages and manages the relationship with the key trade association workgroups and engage relevant staff within the Centers for Medicare and Medicaid Services (CMS). The areas of remit within the purview of the Director, Reimbursement Policy include, but are not limited to: Work with multiple cross-functional teams, analyze access and payment policies proposed by government and commercial payers - including rules and guidance from the Centers for Medicare & Medicaid Services (CMS) - and assess implications for the GSK and ViiV portfolios, including pipeline assets. Remain current on evolving policy and reimbursement issues, including but not limited to, Medicare Parts A & B policies, Medicaid policies, , drug pricing policy proposals (ASP, Medicaid Drug Rebate Program, 340B, etc.), and value-based payment initiatives; educate internal stakeholders on these issues and current developments. Support and develop GSK's reimbursement policy positions, analyze complex reimbursement policy issues and prepare succinct analyses providing strategic, thoughtful advice on their implications. Engage with relevant CMS staff responsible for payment, coverage and reimbursement policy issues. Be an internal reimbursement expert and collaborates across functions to execute or advise on analyses of reimbursement policy proposals that may affect GSK and ViiV products. Facilitate and guide analyses on emerging policy issues related to access and reimbursement of GSK and ViiV products. Lead development strategy to coordinate, complete and file all relevant coding applications with required key organizations Maintain network of external consultants to model impact of evolving policy and payment changes across stakeholders. Participate in assigned trade association work groups to both represent GSK's interests and report back to GAPP to inform advocacy strategies regarding reimbursement policy issues. This position has no direct reports and will report to the VP/Head, US Public Policy. Why you? Basic Qualifications: Bachelor's degree or equivalent; advanced degree preferred. 5+ years of experience in reimbursement policy at the national level, including coverage, coding, and payment of healthcare products or services. Broad knowledge and understanding of healthcare reimbursement environment including coverage, coding, and payment, as well as how to develop, implement and manage reimbursement programs. Previous experience and knowledge of Medicare parts A and B Previous experience working with federal healthcare programs, commercial payers/providers and managed care organizations. Familiarity with process for applying for HCPCS, CPT, and ICD-10 codes as well as NTAP and pass-through status applications Demonstrated analytical and independent problem-solving skills; ability to exercise sound, independent judgment; and drive collaborative decision-making Preferred Qualifications: Prior pharmaceutical or device industry experience or experience within government agencies (eg CMS) is preferred A strategic mindset with a focus on flawless execution of key projects Self-starter with proactive approach, excellent time management and prioritization skills Excellent written, verbal, and interpersonal skills Experience presenting to, communicating with, and influencing senior management Why GSK? At GSK, we have already delivered unprecedented change over the past four years, improving R&D, becoming a leader in Consumer Health, strengthening our leadership, and transforming our commercial execution. Now, we're making the biggest changes we've made to our business in over 20 years. We're on track to separate and create two new companies in 2022: New GSK with a leading portfolio of vaccines and specialty medicines as well as R&D based on immune system and genetics science; and a new world-leading consumer healthcare company of loved and trusted brands. With new ambition comes new purpose. For New GSK, this is to unite science, talent and technology to get ahead of disease together - all with the clear ambition of delivering human health impact; stronger and more sustainable shareholder returns; and as a new GSK where outstanding people thrive. Getting ahead means preventing disease as well as treating it. How we do all this is through our people and our culture. A culture that is ambitious for patients - so we deliver what matters better and faster; accountable for impact - with clear ownership of goals and support to succeed; and where we do the right thing. So, if you're ready to improve the lives of billions, join us at this exciting moment in our journey. Join our challenge to get Ahead Together. *LI-GSK If you require an accommodation or other assistance to apply for a job at GSK, please contact the GSK Service Centre at 1-877-694-7547 (US Toll Free) or +1 801 567 5155 (outside US). GSK is an Equal Opportunity Employer and, in the US, we adhere to Affirmative Action principles. This ensures that all qualified applicants will receive equal consideration for employment without regard to race, color, national origin, religion, sex, pregnancy, marital status, sexual orientation, gender identity/expression, age, disability, genetic information, military service, covered/protected veteran status or any other federal, state or local protected class. At GSK, the health and safety of our employees are of paramount importance. As a science-led healthcare company on a mission to get ahead of disease together, we believe that supporting vaccination against COVID-19 is the single best thing we can do in the US to ensure the health and safety of our employees, complementary workers, workplaces, customers, consumers, communities, and the patients we serve. GSK has made the decision to require all US employees to be fully vaccinated against COVID-19, where allowed by state or local law and where vaccine supply is readily available. The only exceptions to this requirement are employees who are approved for an accommodation for religious, medical or disability-related reasons. Important notice to Employment businesses/ Agencies GSK does not accept referrals from employment businesses and/or employment agencies in respect of the vacancies posted on this site. All employment businesses/agencies are required to contact GSK's commercial and general procurement/human resources department to obtain prior written authorization before referring any candidates to GSK. The obtaining of prior written authorization is a condition precedent to any agreement (verbal or written) between the employment business/ agency and GSK. In the absence of such written authorization being obtained any actions undertaken by the employment business/agency shall be deemed to have been performed without the consent or contractual agreement of GSK. GSK shall therefore not be liable for any fees arising from such actions or any fees arising from any referrals by employment businesses/agencies in respect of the vacancies posted on this site. Please note that if you are a US Licensed Healthcare Professional or Healthcare Professional as defined by the laws of the state issuing your license, GSK may be required to capture and report expenses GSK incurs, on your behalf, in the event you are afforded an interview for employment. This capture of applicable transfers of value is necessary to ensure GSK's compliance to all federal and state US Transparency requirements. For more information, please visit GSK's Transparency Reporting For the Record site.PDN-961eeac2-f0bd-417d-b6e4-a69bccabc038

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