DK Pierce & Associates, Inc.

Love to go down research rabbit holes? Enjoy a mix of collaboration and solo work? Want to be part of a big-hearted mission? If so, this might be the role for you!

We’re looking for an in-house consultant in payer business intelligence to dive deep in the world of payers, reimbursement trends, and changes that impact patient access to life-changing biopharmaceutical treatments. You’d be using your sleuthing and critical thinking skills to track and pull-out key insights in payer coverage, coding, and payment information for a variety of cutting-edge drug products, diagnostics, and procedures.

 

This is a unique opportunity to apply your knowledge and expertise surrounding U.S. health policy and health system stakeholders from a fascinating perspective in a supportive, collaborative environment. You’ll also get a front row seat to first-in-class treatments and the impact on patient lives. And since the healthcare world seems to change by the minute, you’ll always be on your toes and learning something new. Sure, we’re looking for a payer business intelligence consultant, but what we really need is an archaeologist of sorts—a curious, self-starter who can sift through all kinds of resources and find valuable insights that tell a story.

This fast-paced, multi-faceted role will encompass these areas:

 

Payer intelligence tracking, documentation, and communication

• Track/monitor a variety of activities and trends daily within the payer environment, such as general and drug-specific coverage, coding, and payment policies
• Understand key relationships with payer influencers such as pharmacy, oncology or laboratory benefit management companies and specialty pharmacies
• Identify key regulations that will affect drug coverage and access for patient care
• Capture and organize payer information related to drug coverage, coding and payment
• Design client communications on important payer-specific information that may impact the client’s strategic planning and patient access to care with specific treatment options
• Track, develop and foster possible contact relationships with payer entities and their external contractors for direct communications and primary research
• Serve as a client point of contact to triage key questions on payer business intelligence activities/reporting

 

Data quality and report integrity

 

• Review payer information to ensure accuracy and validity of presented information, and develop corrective action plans as needed
• Analyze research results and prepare concise summaries and reports for internal and external dissemination
• Ensure accurate input and maintenance of relevant findings

Teamwork

 

• Establish a highly collaborative working relationship with other consultants, to consistently share findings and expand knowledge from the entire payer environment, including Medicare, Medicaid, commercial and the Health Insurance Marketplace
• Accomplish team goals within the agreed upon time frame while meeting or exceeding quality expectations
• Work with the Payer Business Intelligence team to develop and evolve client-specific online reporting tools and query systems

 

EDUCATION AND/OR EXPERIENCE

 

• Bachelor’s degree in a related field
• Advanced/specialized degrees a plus (MPH, MBA, MSW, etc.)
• Minimum of three years’ demonstrated experience with strong, successful track record in healthcare policy and reimbursement background
• Experience in medical or hospital practice, insurance, or biopharma industry
• Direct experience working with Medicaid fee for service agencies and/or managed Medicaid plans, Medicare Parts B, C and D, or commercial payers (
• Technical knowledge related to drug and healthcare delivery, including coding systems (e.g., CPT HCPCS, ICD-9, ICD-10, NDC), claims payment methodologies (e.g., ASP, AWP), utilization management processes (e.g., formulary tier design, prior authorization criteria)
• Experience with navigating and interpreting information stored within payer websites, like clinical policies, prior authorizations, specialty pharmacy drug lists, Preferred Drug Lists (PDL), fee schedules, open meetings, relevant contacts
• High proficiency with MS Office Suite, particularly Excel and PowerPoint, with the ability to learn other software as needed

 

KNOWLEDGE, SKILLS, AND ABILITIES

 

• Knowledge of medical and pharmacy payer policies and requirements a plus
• Excellent ability to comb through and analyze third party payer coverage, coding, and payment information
• Strong verbal and written communication skills
• Ability to think logically and problem-solve in order to analyze situations, troubleshoot, and make sound decisions
• Can tackle multiple tasks simultaneously, manage projects, and meet deadlines
• Demonstrated database experience, including input, report management, and updates
• Self-motivated, proactive, and customer-focused, with a powerful sense of accountability
• Willingness to travel for occasional client, company, or industry meetings and events as needed
• Can demonstrate flexibility in a fast-paced, dynamic work environment
• Willing to take on tasks/responsibilities with autonomy and creativity as we are a growing company

BENEFITS AND PERKS:

• Competitive compensation program (salary + bonus)
• Employer Stock Ownership Plan – you become an employee-owner!
• Serene office setting surrounded by wooded walking trails
• Company culture of caring and innovation
• 401K with employer match
• Paid PTO and charity days
• Robust medical, dental, vision benefits
• Dogs (well-behaved ones) welcome in the office
• Wellness challenges and rewards

 

 

 ABOUT DKP

We’re not your average consultants. And this isn’t your average workplace. Around here, we get fired up about the meaningful work we do. (And we have a ton of fun doing it.)  

DKP’s mission? To help people struggling with catastrophic medical conditions get access to the treatments they need. With a history of working in biopharmaceutical market access for more than two decades, we provide strategic and tactical services across the entire lifecycle of oncology, rare-disease, and gene and cell therapy products. At the end of the day, everything we do is focused around patients. Based in Zionsville, Indiana, we are an employee-owned, award-winning company that has been named one of Indiana’s Best Places to Work. 

 

 

LOCATION

This is a full time position based in Zionsville, IN, with a Monday through Friday work schedule.