Robert W. Phipps
Jacksonville,USA
Summary
A seasoned leader in market access and sales operations, I've spearheaded strategic initiatives at Cardiac Insight, Inc, enhancing product reach and profitability. My expertise in policy development and collaborative leadership has driven significant organizational growth. With a track record of merging teams for efficiency, my approach has consistently delivered above-target results.
Overview
33
33
years of professional experience
Work History
Sr. Director Market Access and Sales Operations
Cardiac Insight, Inc
01.2018 - Current
- Responsible for market access strategy for Cardiac Insights lead product (Cardea SOLO – Cardiac Event Monitor)
- Accountable for development CMS Category III and Category I reimbursement strategy along with communication to CMS and Local Medicare Carrier (MAC)
- Responsible for commercial payer medical policy development and commercial payer CPT physician reimbursement
- Engage with GPOs to manage pricing contracts
- Manage reimbursement support for physicians and patients
- Liaise with field sales and physicians to assist with EOB denials and payer reimbursement issues which arise
- Responsible for development of Market Access Marketing and Training Material for field sales
VP, U.S. Market Access Sales and Specialty Pharmacy Distribution
Stallergenes Greer
10.2012 - 02.2017
- Responsible for strategy development combined with leading an executive account team (2) whose mission is to provide overall market access support for formulary placement, policy development as well as patient distribution and HUB reimbursement
- Act as chair for pricing, contracting and health econ advisor within Stallergenes Greer
- Develop accurate payor medical policies, contracts, forecasts
- Execute tactical payor sales plans, including quotas and account objectives within Health Plans, Pharmacy Benefit Managers (PBMs), Government Groups (Medicaid, Tricare, VA) and Specialty Pharmacies
- Maintain network of specialty pharmacies, reimbursement hub, Copay & Patient Assistance Programs to service Stallergenes Greer pharmaceutical products
- Act as training lead for field sales rep on all Market Access matters
General Manager Sales
Implantable Provider Group, Inc
04.2007 - 10.2012
- Develop sales and marketing strategies for KOLs, ASC/Hospitals, Payors with special emphasis on devices, implants (ortho, pod, neuro stims, pain pumps, etc); high cost disposables
- Responsible for overall medical policy development
- Accountable for field management of 18 sales and marketing reps, 245 Ambulatory Surgery Centers and Outpatient
- Launched 1st of its kind device benefit manager program for Blue Cross Blue Shield Florida, Blue Cross Blue Shield of North Carolina, Capital Blue PA, AETNA, Anthem BCBS and CIGNA
Sales Manager
BioPharma Partners, LLC
09.2006 - 05.2007
- Developed agency brand for companies – BioPharma, Oncomed & YgeneX
- Developed offering to customers which included education of Managed Care, consulting services aimed at genomics, biotech & pharma advisory forums, HUB/Reimbursement support, white papers, CE/CME programs, dossiers EBM guidelines, branding campaigns, product launch campaigns, econ modeling
VP, Managed Care Sales and Business development
Pinsonault Associates, LLC
04.2004 - 09.2006
- Direct sales and business development team of six people
- While at Pinsonault I was charged with bringing Today’s Account’s Reimbursement HUB to life
- HUB design consulting for: Genzyme, Roche, Abbott, Centocor, Steifel, Pfizer, Alkermes and Oscient
VP, Managed Markets and Government Affairs
Serono, Inc
09.2001 - 03.2004
- Direct managed care, government affairs, government relations (DC) and contract group for Reproductive Health, Neurology and Metabolic therapies for U.S
- And Canada
- Manage internal and external staff of 35 people
- Member of the Serono twelve (12) member board for North America
- Responsible for $390M worth revenue in 2003
- Responsible to MS Lifelines reimbursement and nursing support Hub and responsible for a staff of 55 FTE’s
- Accomplishments: Built Neurology Managed Care and Gov’t Affairs team to prepare launch of Rebif in the U.S.; merged three (3) business units and Gov’t groups together into one division (shared service)
- Built new therapy division for Phase II and III product development
- Winner of CEO Award of Excellence for Business acumen, profitability and sales
Exec. Director, U.S. Managed Care & Government Relations
Novartis Ophthalmics
01.1998 - 09.2001
- Direct all activities and personnel associated with Managed Care, Managed Care Contracting, Reimbursement, Gov’t Affairs, and Rebates
- Direct, Develop and execute Managed Care, reimbursement and Contract strategies for 'core', 'retina' and 'surgical' business, which drive sales, and maximize contractual profitability
- Direct Activity for U.S., which also includes Hawaii & Puerto Rico
- Develop/direct Retina (Visudyne, Vitravene) reimbursement strategies for physician reimbursement
- Ensure timely payment by HCFA and other 3rd party payers direct to physicians
- Resolve physician reimbursement issues in regards to Retina
- Develop and implement ongoing Managed Care training for Corporate Account Managers & Retina group in coordination with Novartis Ophthalmics training department
- Direct & Develop Government compliance strategies/protocols which allows Novartis Ophthalmics to be compliant with all Federal OBRA 90 & 93 regulations which ensures compliance with all HCFA guidelines
- Direct 16 State and 8 federal lobbyists in Washington, DC to ensure proper legislative activity with key congressional contributors and senators
- Direct all dispute resolution activity for a 50 state area
- Develop, Direct & implement new AMP, BP, retail and non-retail methodology to ensure compliance and NDC (product) profitability
- Develop and implement disease state management programs offered to MCO's
- I.e
- Pure Focus
Pharmacy Director-West Southwest ops.
Prudential HealthCare Pharmacy Services
04.1996 - 01.1998
- Responsible for conducting on-site pharmacy audits & account mgmt for west/southwest operations
- Recovery of on-line and manually submitted PPO/MPO or pharmacy claims in error, investigate potential fraudulent activity, work closely with sales to manage overall client satisfaction, provide cost analysis to Plan on Plan savings, assist pharmacies with provider education as well as keeping pharmacies in compliance with HMO contract as well as all applicable state and federal pharmacy regulations
Director Pharmacy Mgmt
Inter Valley Health Plan (HMO)
05.1994 - 10.1996
- Develop new pharmacy benefits, work closely with sales in training and implementation of benefits, audits pharmacy data and retail pharmacies, approve/deny non-form drugs based on plan protocols, co-chair for pharmacy committee in regards to the drug formulary, negotiate pharmaceutical contracts in regards to pharmaceutical manufacturer discounts as well as negotiate pharmacy provider contracts, interpret HCFA and DOC guidelines, provide in-service through departments and HMO providers, determine Q.I
- Issues to be forwarded to Plan Medical Director and Vice President, make open presentations regarding pharmacy benefit parameters to employer groups and/or brokers
Pharmacy Manager
Longs Drugs, Inc.
03.1992 - 05.1994
- Responsible for 3rd
- Party electronic and hand billed claims, Medi-Cal and TAR’s, filing and typing of Rx’s, specially trained to handle all questions regarding Longs diabetic program, in charge of all pharmaceutical ordering and credit
Education
BS - Biology, Ecology
Charter University
Skills
- Policy development
- Collaborative leadership
- Team management
- Team building
- Team building and motivation
- Organizational development
References
References available upon request.
Timeline
Sr. Director Market Access and Sales Operations
Cardiac Insight, Inc
01.2018 - Current
VP, U.S. Market Access Sales and Specialty Pharmacy Distribution
Stallergenes Greer
10.2012 - 02.2017
General Manager Sales
Implantable Provider Group, Inc
04.2007 - 10.2012
Sales Manager
BioPharma Partners, LLC
09.2006 - 05.2007
VP, Managed Care Sales and Business development
Pinsonault Associates, LLC
04.2004 - 09.2006
VP, Managed Markets and Government Affairs
Serono, Inc
09.2001 - 03.2004
Exec. Director, U.S. Managed Care & Government Relations
Novartis Ophthalmics
01.1998 - 09.2001
Pharmacy Director-West Southwest ops.
Prudential HealthCare Pharmacy Services
04.1996 - 01.1998
Director Pharmacy Mgmt
Inter Valley Health Plan (HMO)
05.1994 - 10.1996
Pharmacy Manager
Longs Drugs, Inc.
03.1992 - 05.1994
BS - Biology, Ecology
Charter University
Similar Profiles
Jarrai JallowJarrai Jallow
Registered Nurse at Carolinas Medical Center - Dickson, Cardiac ICURegistered Nurse at Carolinas Medical Center - Dickson, Cardiac ICU
Taylor PickleTaylor Pickle
Registered Nurse at Maury Regional Medical Center (Cardiac Stepdown/ Short Stay Unit)Registered Nurse at Maury Regional Medical Center (Cardiac Stepdown/ Short Stay Unit)
Shari H. HarrisShari H. Harris
Cardiac Cath Lab Imaging Technologist at St. Dominic’s Hospital Cardiac Cath LabCardiac Cath Lab Imaging Technologist at St. Dominic’s Hospital Cardiac Cath Lab
Corinne Berg, MSN, RN, PHNCorinne Berg, MSN, RN, PHN
Registered Nurse at Mayo Clinic Center for Individualized Medicine, Mayo Clinic EnterpriseRegistered Nurse at Mayo Clinic Center for Individualized Medicine, Mayo Clinic Enterprise
GARRETT LOPEZGARRETT LOPEZ
Master-at-Arms at US NavyMaster-at-Arms at US Navy