The “Sr. Director, Commercial Operations” will be a foundational member of the Commercial team who will contribute to shaping and executing the payer/provider penetration plan, developing sales support collateral, and building out the contract operations processes. This crucial role will be responsible for applying a scientific approach to the overall commercial strategy to inform the launch strategy and execution at launch across the multiple divisions within the commercial team. This person will work closely with Market Access operations as well as field sales operations and sales, and cross functionally with Marketing, Product, Clinical, and Medical Affairs.
Additionally, this individual will build out the operational infrastructure at Cognoa including contract development and assessment, forecasting and tracking, gross to net, pre/post deal analytics, tracking pull-through, etc.
Strategy and Execution
- Work closely with Cognoa’s commercialization partner to develop Market Access / Field Sales collateral and a go-to-market strategy that aligns with the company goals and commercial organization – many of this work is outsourced right now, so this position will ensure that timelines are met, that the project is on track with the launch date/plan, and the proper people at Cognoa are included and updated.
- Completing payer and provider segmentation and work across sales organizations to drive market penetration.
- Support the sales team with all of their needs as it relates to contracting and value proposition (budget impact models, HEOR value story, segmentation, targeting)
- Build a platform to support contract strategy, including data analysis from various sources and tools. This person would be required to recommend certain solutions as they pertain to our product and therapeutic area.
- Manage the Market Access relationship with Cognoa’s commercialization partner to drive a successful launch.
- Assist with ad boards and primary research where necessary.
- Continually adapt the coding strategy for CPT codes and HCPCs codes as congress moves legislation forward.
- Ability to weigh in on pricing strategies as it relates to payer adoption.
- Work closely with data analytics and the hub / specialty pharmacy provider to map out de-identified patient data to 3rd party claims and build out a predictive analytics solution to define patient journey and build a continually improving HEOR story.
Contract Development and Operations
- Build a contract / medical policy strategy, and align gross to net contracting scenarios to organizational revenue goals.
- Build payer specific forecast models for pre/post-deal analytics based on payer control and influence over providers and analog growth curves.
- Negotiate contract terms based on the organizationally agreed upon definition of coverage, and manage complex contract language.
- Model and present discount and coverage terms against growth curves and break-even and contracted/non-contracted scenarios to the core leadership team for contract approval.
- Find and implement a solution for operationalizing contract terms, and ensure that detailed claims data files are billed and paid correctly.
- Work closely with the hub/sp team to ensure minimal revenue leakage from inappropriately billed/reimbursed claims.
- Manage forecasted accruals against actuals with finance.
- Manage the downstream dissemination of accurate data to various stakeholders including finance, sales, data science, marketing, and product.
- Manage Master Data and Class of Trade assignment to ensure contract eligibility.
- Define and develop Standard Operating Procedures (SOPs) for all processes defined.
- Deep understanding of the different contract scenarios within medical device and pharmaceutical products, including risk based, value based, and fixed net price contracts, and ability to negotiate price protection and contract compliance.
- Strong Data Analytics, Forecasting, and Contract Negotiation skills.
- Ability to work with external stakeholders at all levels.
- Strong understanding of 3rd party claims aggregators and additional tools.
- Ability to find and work with the top vendors in the space.
- Ability to build relationships cross-functionally to execute on organizational goals.
- Ability to present to appropriate parties at all levels (analyst to CEO).
- 5+ years experience working at a pharmaceutical or medical device manufacturer in a brand team or a Market Access function, with launch experience preferred
- 5+ years experience working in operations at a scaled, multi-channel, organization (Medicaid, Commercial, Managed Medicaid), with a strong understanding of claims level detail utilization files
- Management experience required
- 5+ years experience with field operations including forecasting, primary research, and strategy development
- Experience working with 3rd party claims aggregators
- Experience managing multiple vendors for multiple services at the same time
- Proven ability to build and maintain relationships with internal/external stakeholders