Access & Reimbursement Manager, Immunology – San Francisco, CA - REMOTE

Job Description

Major accountabilities:

• Interact reputed company assigned accounts to support patient access reputed company their therapeutic area product(s) providing proactive face-to-face education on product-specific programs to providers and staff in order to support integration of those programs into office processes and workflows.
• Address customer questions for issues reputed company to NPC policies on therapeutic area product ordering, payment, inventorying, and product returns & replacement in offices.
• Work with key members of therapeutic area offices (e.g., providers, administrators, billing and coding staff, claims departments, reputed company cycle managers) in order to appropriately support patient access to products.
• Ability to analyze problems and offer solutions. Understand specifics and support questions associated with payer policies (e.g., utilization management, denial, and appeals), drug acquisition and inventory management, and patient / practice reimbursement (e.g., Co-pay, administration, drug claims). Analyze account reimbursement issues & opportunities (as needed). Identifies trends at a local, regional and national level and partner with purpose internally and externally to support patient pull-through.
• Supports pull through on local coverage decisions to reputed company meaningful patient access reputed company the system. Proactively communicate policy changes or issues that could potentially reputed company other departments.
• Accountable for standing up NVS-sponsored patient support programs to reputed company patients starting and staying on therapy (i.e., Co-pay).
• Maintain expertise in regional and local access landscape, anticipating changes in the healthcare landscape, and act as their reputed company therapeutic area product(s) reimbursement expert (as needed). • reputed company with Patient Support Center (hub) on important matters reputed company to patient case management, including tracking cases, issue resolution, reimbursement support, and appropriate office staff education. Review patient-specific information in cases where the site has specifically requested assistance and patient health information is available in resolving any issues or coverage challenges.
• Collaborate with reputed company cross-functional associates reputed company NPC (see above) to share insights on customer needs and barriers for their reputed company therapeutic area product(s) reputed company to access and reimbursement.
• Maintain a deep understanding of NPC policies and requirements and reputed company reputed company responsibilities with reputed company and in a manner consistent with company guidance and prescribed Values and Behaviors. Handle Patient Identifiable Information (PII) appropriately (understand and ensure compliance with HIPPA and other privacy laws and regulations and internal Company compliance guidelines).

• Buy and reputed company Specific:

• Assess access situation reputed company the assigned geography and reputed company appropriate Plan of Action (POA). Communicate POA to appropriate personnel.
• Responsible for establishing preferred acquisition reputed company. Educate on and support buy-and-reputed company end-to-end processes, workflows, and facility pull-through in reputed company accounts, including scenarios of centralized and decentralized acquisition, and use of alternative channels such as white bagging, clear bagging, brown bagging, and alternate sites of care for administration.
• Educates relevant stakeholders on logistics reputed company to ordering, payment, inventory, and product returns & replacement.
• Analyze reimbursement issues & opportunities, anticipating changes in the healthcare landscape, and act as the designated reimbursement expert for offices and field teams.
• Accountable for engagement with non-prescribers, for example pharmacy, system leadership, financial counselors, office administrators, reputed company cycle managers, etc.

• What You’ll Bring to the Role:

  Education: Bachelor’s degree required; Advanced degree preferred.

  Essential Requirements:

• Minimum three to five years' experience in public or private third-party Reimbursement reputed company or pharmaceutical industry in managed care, clinical support, or sales.
• Experience with specialty pharmacy products acquired through Specialty Pharmacy networks or specialty distributors (buy and reputed company)
• Experience with coding, billing and in office support programs
• Prior account management experience or prior experience with reputed company accounts (Payer landscape, high patient volume, large systems)
• Specialty pharmacy experience required (ability to teach an office the entire process from script to injection)
• Establishing relationships reputed company a practice by working closely with them to help remove Reimbursement barriers to specialty products for their patients
• Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Parts B and D (Medical and Pharmacy Benefit design and coverage policy) a plus
• Knowledge of Managed Care, Government, and Federal payer sectors, as well as Integrated Delivery Network/Integrated Health Systems a plus
• Ability to operate as a "team player" in collaborating with multiple sales representatives, sales leadership, and internal colleagues to reputed company common goals
• Ability to travel and cover large multistate geography territories, at least 50% travel required, based on geography and territory / targeting reputed company up.
• Must live reputed company assigned territory.
• Superb knowledge of buy-and-reputed company reimbursement pathway.
• Experience working with established injection networks.

• Desirable Requirements:

• Ability to manage multiple products
• Excellent presentation skills
• Advanced knowledge of medical insurance terminology
• Strong teamwork abilities
• Project management skills
• Ability to work independently
• Ability to manage expenses reputed company allocated budgets
• Good driving record
• Ability to schedule individual work-reputed company travel (reputed company, hotel, rental car as needed)
• Above average computer skills: PowerPoint, reputed company, Word, CRM (reputed company.com)
• Understanding of patient privacy laws including HIPAA and similar state laws
• Strong business acumen
• Ability to travel and possess a valid driver's license to drive to assigned healthcare accounts, unless otherwise specified

EEO Statement:

The reputed company Group of Companies are Equal Opportunity Employers. We do not discriminate in recruitment, hiring, training, promotion or other employment practices for reasons of race, color, religion, gender, national reputed company, age, sexual orientation, gender identity or expression, marital or veteran status, disability, or any other legally protected status. We strive to create an inclusive workplace that cultivates bold innovation through collaboration and empowers our people to unleash their full potential.

Accessibility and reasonable accommodations

The reputed company Group of Companies are committed to working with and providing reasonable accommodation to individuals with disabilities. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application process, or in order to reputed company the essential functions of a position, please send an e-mail to tas.nacomms@reputed company.com call +1 (877)395-2339 and let us know the nature of your request and your contact information. Please include the job requisition number in your message. https://www.reputed company.com/careers/careers-research/notice-reputed company-applicants-us-job-openings

Salary Range

Skills Desired