Field Reimbursement Director

Head Of Field Reimbursement

Osteal Therapeutics is a Dallas-based, privately held biotechnology company redefining the standard of care for life-altering orthopedic infections. Osteal is hiring to launch NEXCHANGE KIT, a first-of-its-kind FDA Breakthrough Therapy for periprosthetic joint infection (PJI), a critical condition impacting 50,000 Americans annually. PJI currently lacks FDA-approved therapies and forces patients through grueling, months-long treatments with poor outcomes. Our disruptive technology transforms this journey by safely delivering high-concentration, broad-spectrum antibiotics directly to the infection site; reducing the treatment timeline from months to just seven days.

Powered by $137M in funding to date and a distinguished investor base that includes strategic partners Johnson & Johnson and Zimmer Biomet, we are advancing toward FDA approval and building the organization that will bring this therapy to patients in dire need.

We are looking for bold, relentless professionals who thrive in a "builder" environment. If you are driven by the opportunity to do work that genuinely matters to be part of a cohesive and capable team striving to deliver the first on-label PJI treatment that promises to transform outcomes for tens of thousands of patients.

About The Role The Head Of Field Reimbursement is an exciting opportunity to make a meaningful impact for patients. This is a remote, field-based role. This role will report into the Senior Director Of Market Access And Heor. The Frm will support the launch of an upcoming drug, exclusively in the inpatient setting, for use during surgical procedures. They will work in collaboration with the sales and market access teams to provide full support to hospitals. Unlike buy-and-bill outpatient drugs, inpatient drugs are bundled into a drg payment, often not separately reimbursed, and can be financially risky for hospitals. The Frm will play a critical role in communicating the financial story to hospitals with a budget impact model and understanding of the standard of care reimbursement dynamics. This role will educate on ms-drg, ntap, and outlier payments. They will also support proper coding of icd-10-pcs procedure codes, accurate diagnosis capture, and proper documentation. Inservice support providing hospital education and managing objections will be imperative. This is a strategic leadership role and will be responsible to build out and hire a team of field reimbursement managers over the next 6 months. Financial acumen and soft skills to ensure an open and ongoing relationship with hospitals is imperative. Operating within a fast-paced, pre-commercial environment, this individual will partner cross-functionally to align strategy and execution, while proactively navigating reimbursement, policy, and health system dynamics to optimize patient access and account performance.

Responsibilities of the position include but are not limited to the following. Other duties may be assigned.

• In the first 6 months, Frd will build out a full field reimbursement team to support an upcoming launch.
• Provide training, guidance, oversite, and support to Frms.
• Support an integrated approach to hospitals, in collaboration with market access to delivers optimal access for patients, ensuring an efficient cross-functional communication and feedback process.
• Engagement with hospital staff educating them on ms-drg inpatient hospital payments, ntap, and outlier.
• Provide critical support to coding teams, cdi, and revenue cycle hospital teams.
• Ensure correct icd-10-pcs procedure coding, accurate diagnosis capture, and proper documentation to support severity.
• It is vital that the Frd develops and maintains a strong relationships with each hospital, while understanding the financial risk of hospitals (idns, etc.), and what costs are affecting their margin.
• Work together with sales and market access hospital teams in owning the hospital relationships and troubleshooting issues.
• Implement approved educational programs regarding access, reimbursement, and fulfillment topics.
• Serve as a brand leader in the field for hospitals to call when coding, access, and reimbursement questions arise.
• Support the market access field team in delivery and use of the budget impact model and ad hoc modeling to aid hospitals in complex financials.
• Provide strong analytical work to improve process and performance, identify key metrics to track performance at a national and regional level.

Requirements

• Bachelor's degree required
• 8+ years' experience within the pharmaceutical/biotech industry in a role related to either sales or access
• Experience working in reimbursement is required
• Experience in hospital reimbursement / drgs is required
• Comprehensive understanding of the full reimbursement continuum; coding, coverage, and payment across inpatient and outpatient settings and all major payer segments.
• Ability to own and build critical relationships with office staff and partner to provide support, as needed
• Strong financial and business acumen, with the ability to analyze total cost of care, evaluate economic impact, and translate insights into actionable account strategies.
• Some customers may have certain credentialing requirements that apply to field roles to gain access to preform the essential functions of the position. In these cases, credentialing requirements must be met (which may include vaccinations such as covid-19).
• Executive presence and a history of interfacing with high level health system executives.
• Ability to manage multiple priorities and thrive in a fast-paced, evolving organization.

Our Benefits

• 100% of health insurance paid by ostealtx for employee & dependents
• Dental & vision insurance
• Short & long term disability insurance paid 100% by ostealtx
• 401k (regular & roth)
• holiday pay & pto
• Competitive compensation: base ($220,000 - $250,000) + bonus + equity

Osteal Therapeutics is an equal opportunity employer. All employment decisions are based on business needs, job requirements, and individual qualifications, without regard to protected characteristics such as race, color, religion, sex, national origin, age, disability, or veteran status.

Osteal Therapeutics