Director, Reimbursement Analytics

About Us:

Founded in 2017 and based in Chicago, Meitheal is focused on the development and commercialization of generic injectable medications and, as of 2022, has expanded its focus to include fertility, biologic, and branded products. Meitheal currently markets over 60 U.S. Food and Drug Administration (FDA)-approved products across numerous therapeutic areas including anti-infectives, oncolytics, intensive care, and fertility. As of January 2025, Meitheal, directly or through its partners, has 19 products in the research and development phase, 22 additional products planned for launch in 2025, and 24 products under review by the FDA. Meitheal's mission is to provide easy access to fairly priced products through robust manufacturing, consistent supply, and rapid response to our customers' needs. Ranked #2 in 2024 on Crain's Fast 50 in Chicago, and in the top 100 of Crain's Best Places to Work in Chicago from 2022 to 2024, Meitheal emulates the traditional Irish guiding principle we are named for - working together toward a common goal, for the greater good.

Learn more about who we are and what we do at www.meithealpharma.com.

Learn about our benefits at Meitheal Benefits

Position Summary:

The Director of Reimbursement Analytics is responsible for providing strategic and tactical reimbursement expertise, defined broadly to include how products are covered and paid for by Commercial and Government payers under pharmacy or medical benefit. This includes understanding payer coverage policy criteria, patient out of pocket costs and programs, and coding/payment dynamics across Meitheal's brand, specialty and biosimilar products. The Director of Reimbursement Analytics will work closely with Market Access, Trade, Pricing and Contracting, Marketing, Legal, Compliance and other relevant stakeholders. This individual is accountable for understanding and aligning to the brand strategy and identifying and recommending solutions to patient access barriers. This position reports to the Head of Reimbursement Services.

Payrate is determined by considering a person's prior experience and competence.

Why Work with Us?

* Hybrid Work Schedule: Enjoy the flexibility to work remotely three days a week.

* Casual Dress Code: Embrace a relaxed and comfortable dress code that allows you to express your personal style.

* Collaborative Culture: Join a team that values open communication, teamwork, and the exchange of ideas.

* Professional Growth: We offer ample opportunities for professional development and career advancement.

Essential Duties and Responsibilities include the following. Other duties may be assigned.

• Responsible for leading Reimbursement claims data initiative (Remit Data) internally across multiple cross-functional teams and helping develop key business implications and takeaways.
• Execute numerous reimbursement-related workstreams across medical benefit medicines (i.e., apply for a new modifier, business case on applying for unique ICD-10 code, applying for NTAP status, etc.).
• Represent Reimbursement function for specific individual brands and lead initiatives for development of brand-specific billing and coding content.
• Serve as point person from Reimbursement function on workstreams that support lifecycle management and new product development.
• Partner with Compliance and other functions to lead initiatives to share broad national reimbursement data to customers at the field level.
• Develop and maintain a comprehensive understanding of public and private payer reimbursement landscape (national, regional, local) through payer research and collaboration with cross functional partners.
• In collaboration with Pricing and Contracting, assess current and future impact of government policy, federal and state, on reimbursement relative to Meitheal's enterprise.
• Monitor, identify, and assess payer reimbursement trends and communicate potential business impact with team members on relevant changes.
• Act as key point-person for other cross-functional partners, above-brand reimbursement business impact trends and issues, for example copay accumulators, and research potential solutions as directed by leadership.
• Prepare and present market learnings to functional leadership and cross-functional partners.
• Participate as a core member of the reimbursement strategy team and other relevant matrix groups.
• Partner with training to support and drive reimbursement training efforts across the commercial organization.

Qualifications

• Bachelor's degree required.
• Minimum of 7 years of relevant industry experience in healthcare, biotech and/or pharmaceutical industry.* Minimum of 4 years of increasing responsibility in Access and Reimbursement.
• Firm understanding of HIPAA rules and regulations related to patient privacy.
• Experience in new product launches.
• Experience in medical and pharmacy benefit products.
• Deep understanding of access and patient out-of-pocket dynamics including Commercial, Medicare, Medicaid plan design.
• Deep technical knowledge of health care reimbursement from a patient and provider perspective (authorizations, miscellaneous J codes, billing, coding, prior authorizations, appeals, patient and provider support programs and HUB operations).
• Effective interpersonal skills, the ability to develop strong working relationships and work collaboratively.
• Strong oral and written communication skills.
• Excellent planning and organizational skills to work within date-sensitive deadlines.

Equal Opportunity Employer:

Meitheal Pharmaceuticals is an Equal Opportunity Employer. We welcome and encourage applications from all qualified individuals, including minorities, women, veterans, and individuals with disabilities.