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Consultant, Kidney Care and Market Access

LOCATION: Remote
REMOTE ELIGIBLE: Fully Remote
TRAVEL REQUIREMENT: 5% or less
REQUISITION ID: 314
<p>Avalere Health is seeking a Consultant to join its Market Access Practice. This team focuses on a wide range of areas, such as: 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. We assess how our clients’ products fit within the emerging coverage and reimbursement landscape and help our clients optimize market access for their products through deep subject matter expertise and understanding of their business issues.</p> <p>Avalere continues to grow its capabilities focused on providing strategic market access guidance to manufacturers, payers, providers, and third-party entities in the evolving kidney care space. Avalere leverages its experience and deep expertise in the CKD and ESRD therapeutic areas and payment systems to help our clients identify solutions in this space.</p> <p><strong>Responsibilities</strong></p> <ul> <li>Serve as a subject matter expert on reimbursement and market access-related issues in the CKD, ESRD, and kidney transplant space impacting life sciences, payer, and provider stakeholders;</li> <li>Manage multiple mid-to-large sized kidney care projects and other market access projects for clients, assembling cross functional, practice teams from project initiation through project delivery;</li> <li>Lead cross-functional teams to solve complex client problems in the kidney care and broader market access space, and engage clients with novel solutions and ideas related to market access strategy, public policy and market trends, commercialization challenges, and operational considerations;</li> <li>Drive the development of both strategic and tactical recommendations for clients to ensure optimal market access for client products and/or payment for services;</li> <li>Solve complex client issues in a timely and appropriate manner with minimal management oversight and attention to resources;</li> <li>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;</li> <li>Manage multiple clients and short- and long-term deliverables to ensure Avalere’s vast knowledge and expertise are available to meet client needs;</li> <li>Support thought leadership on how to identify and develop solutions related to access, payment, and quality of care for patients with CKD, receiving maintenance dialysis, or pre-/post-kidney transplantation;</li> <li>Assist in the evaluation and analysis of both Avalere/Inovalon proprietary data and public data sources to identify payment/care utilization trends in the kidney care space and inform public- and client-facing insights;</li> <li>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 kidney care space;</li> <li>Mentor, supervise, and train staff members within the Market Access &amp; Reimbursement Practice and across the firm;</li> <li>Develop and maintain a professional level of knowledge regarding Avalere’s and Inovalon’s services and products;</li> <li>Maintain compliance with Inovalon’s policies, procedures and mission statement;</li> <li>Adhere to all confidentiality and HIPAA requirements as outlined within Inovalon’s Operating Policies and Procedures in all ways and at all times with respect to any aspect of the data handled or services rendered in the undertaking of the position;</li> <li>Fulfill those responsibilities and/or duties that may be reasonably provided by Inovalon for the purpose of achieving operational and financial success of the company; and</li> <li>Uphold responsibilities relative to the separation of duties for applicable processes and procedures within your job function.</li> </ul> <p><strong>Education/Experience Requirements</strong></p> <p>A bachelor’s degree in health policy, public policy, healthcare management, public health, public administration, health economics, business administration, law, or a relevant discipline with 4+ years of relevant experience; 2+ years of consulting or industry experience is preferred.</p> <ul> <li>Examples of relevant work experience include consulting firms, diagnostics and/or pharmaceutical manufacturers, clinical laboratories with specialty in molecular diagnostics, and the healthcare industry at large.</li> </ul> <p><strong>Other Requirements</strong></p> <p>Subject matter expertise should reflect an expert-level understanding of:</p> <ul> <li>Intricacies of the ESRD PPS 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;</li> <li>Public payer and commercial plan coverage and payment considerations for maintenance dialysis patients, individuals with CKD, and kidney transplantation patients (both pre- and post-transplantation);</li> <li>Patient population characteristics and challenges that drive access challenges and disparities in care options and outcomes;</li> <li>Competitive dynamics for therapeutics within key comorbidities associated with CKD and within key functional categories included under the ESRD PPS bundle;</li> <li>Dynamics of incentives and relationships between dialysis organizations/facilities, nephrologists, and other relevant providers;</li> <li>Role that the mandatory and voluntary CMMI models play in informing payment and care decision-making; and</li> <li>Broader policy trends driving coverage, payment, and quality considerations for dialysis, CKD patient identification and management, and kidney transplantation.</li> </ul> <p>Additional requirements include:</p> <ul> <li>Excellent attention to detail;</li> <li>Proven ability to initiate and drive projects through to completion;</li> <li>Superior oral and written communications skills to clearly and effectively convey pertinent information, issues, reports, and other deliverables;</li> <li>Ability to build trust and cultivate relationships with diverse internal and external stakeholders;</li> <li>Problem definition and resolution skills;</li> <li>Demonstrated ability to manage multiple project teams in parallel;</li> <li>Advanced Word, Excel, PowerPoint, and Outlook skills; and</li> <li>A positive, professional, and solution-oriented attitude.</li> </ul>

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