Contractor (US Payer Policy & Market Access Research),...

Company Overview:

Policy Reporter offers a suite of insights products and consulting services to enhance market access strategies and patient support initiatives. By tracking payer policies in near real time, we ensure that the largest pharmaceutical, medical device and diagnostics manufacturers, leading academic institutions and organized provider groups have the most up-to-date data and evidence-based guidance to help patients access the therapies they need. For more information, please visit .

About the Team:

The Research Team at Policy Reporter conducts research into the US Healthcare landscape to help clients analyze healthcare policy data that impacts market access strategies. We deliver insights to our clients through the quality of our data synthesis as well as the presentation of our findings. Our market research and intelligence services improve the accessibility to medical treatments and products for patients in need and hence improve patient outcomes.

Position Summary:

We are seeking a contractor to assist with our research by performing comprehensive analysis of the US healthcare landscape. This role includes researching healthcare policy data, reviewing and assessing payer-policy information, and creating customized reports based on client requirements. We are looking for a highly motivated individual with experience in Oncology, to provide valuable insights for our clients. The ideal candidate should be able to commit between 20 - 40 hours per week.

• In-depth scientific knowledge and/or previous work experience across different therapeutic areas including but not limited to cardiology, immunology, neurology, nephrology, oncology, and respiratory is preferred.

• Knowledge of the US pharmaceutical, diagnostics, and/or medical device market access landscape is preferred.

• A strong understanding of key concepts such as Policy Coverage, Prior Authorization, Billing and Coding, and Medical reimbursement is preferred.

Role & Responsibilities:

• Investigate and synthesize data into a comprehensive report on coverage requirements for therapeutics/diagnostic testing/medical device from payer policies, forms, and special advisories.
• Update comprehensive payer coverage reports to reflect key changes in coverage requirements and approval processes.
• Ensuring continued high data accuracy and efficiency through thorough quality assurance of the policy data set across existing reports.
• Support the refinement of report templates for displaying payer policy coverage insights that aligns with well-established reporting methodologies.
• Work collaboratively with internal stakeholders to conduct analysis and generate insights in the form of dashboards/visualizations for clients.
• Act as subject matter expert providing insight into medical necessity, prior authorization, payment complexity.
• As required, the Contractor will liaise directly with clients on projects to present findings and answer queries.

Skills Required :

• Intermediate to advanced Microsoft Office Suite, particularly Excel skills
• Research competencies including but not limited to:

• Synthesizing and analyzing insights from large data sets.

• Summarizing, presenting, and validating findings to both internal and external stakeholders.

• Excellent organizational and problem-solving skills.

• High attention to detail.

• Effective verbal and written communication; ability to communicate and present findings to clients in a clear and concise manner.

Experience Required

• A bachelor’s degree (in Life sciences, Pharmacy or Social Sciences preferred)

• Experience in Pharmaceuticals, Oncology, Medical Devices and/or Diagnostics field is preferred.

• Experience collaborating directly with clinicians/healthcare teams an asset.

• Experience with appeals process and compiling cost-benefit analysis an asset.

• 3+ years of professional working experience (Full-time).

• At least 1-2 years Quantitative & Qualitative Research experience preferred.

• Prior knowledge of the US healthcare market access preferred.

• Previous healthcare data experience is considered an asset.

Therapeutic Area Experience:

Pharmaceuticals: 

• In-depth scientific knowledge and/or previous work experience in Pharmaceuticals including but not limited to neurosciences, cardiovascular, metabolic, renal, gastroenterology, infectious diseases areas is preferred.

Oncology/Immunology:

• In-depth scientific knowledge and/or previous work experience in Oncology & Immunology therapy areas is preferred.
• A strong understanding of key concepts such as biomarkers, companion diagnostics, personalized medicine, biosimilars, cell & gene therapies, and monoclonal antibodies is preferred.

Diagnostics:

• In-depth scientific knowledge and/or previous work experience in diagnostic testing areas is preferred.
  
• Knowledge and/or experience in precision medicine and clinical genomics experience is preferred.
  
• Experience in processing/approval of diagnostic coverage claims is preferred
  
• Knowledge and/or experience in working with Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) Codes is preferred.

Medical Devices/Procedures:

• In-depth scientific knowledge and/or previous work experience in medical devices/procedures is preferred.
  
• Expertise of medical device industry standards and compliance with launch and reimbursement experience is preferred.
  
• Knowledge and/or experience in working with Current Procedural Terminology (CPT)/Healthcare Common Procedure Coding System (HCPCS) Codes is preferred.