Job Description

Field Reimbursement ManagerThe Field Reimbursement Manager plays a critical role in facilitating patient access to new therapies by leveraging their expertise in coverage, payer policies, and patient assistance programs. Through education and partnership with office staff, they help navigate the access journey and identify solutions.This role is customer facing and will provide personalized issue resolution by partnering closely with the dedicated patient support (hub) and specialty pharmacy team. They will also collaborate closely with local/regional sales teams supporting targeted accounts, ensuring patients and providers experience minimal barriers to access.This role will support accounts located in Texas, Missouri, Illinois, Michigan, Wisconsin, and Minnesota. They will demonstrate deep understanding of reimbursement and access and act as the subject matter expert in their assigned territory.They will demonstrate extensive knowledge of individual managed care account's geographic presence/influence, payer mix, product coverage and reimbursement criteria policies. They will educate providers on prior authorization requirements, coverage status, payer appeals requirements, alternate funding options for the uninsured and under insured, and all associated processes and timelines.They will provide access education to HCPs and office staff as needed. They will serve as a liaison between sales reps and key external customers.They will create and maintain productive relationships with HCPs, key stakeholders within HCP offices, and health care systems. They will utilize knowledge to assist customers in navigating the complexity of specialty pharmacy distribution.They will partner daily with the specialty pharmacy case management team to ensure accurate coverage determinations, and optimized processing of enrollments for timely access of product for patients.They will partner with the sales team and patient hub/SP to identify both accounts that are experiencing reimbursement issues and specific patients that are not moving forward due to insurance delays.They will develop and implement innovative solutions for patient access with system and individual situations. They will perform strategic analyses to develop business plans that identify issues and opportunities.The role involves significant travel (up to approximately 70% of time). The Field Reimbursement Manager will meet customers, attend appropriate conferences, and is expected to travel in the field with sales and regional colleagues to call upon key providers and influencers.Required skills include a B.S./B.A. degree or higher and 8+ years of experience in the pharmaceutical or biotechnology industry, with expertise in biotech drug distribution across specialty distributors, specialty pharmacies, and hospital systems. They will demonstrate understanding of coverage and reimbursement for oral and injectable therapies.They will have strong expertise in Specialty Pharmacy operations and third-party services (Patient Support). They will have deep knowledge of payer/PBM utilization management tactics for new therapies such as new to market blocks and exclusion lists required.They will have extensive understanding of pharmaceutical manufacturer compliance, patient confidentiality, product reimbursement and product access requirements. They will have knowledge of regulations and laws governing the protection of patient identifying information, and relevant laws, regulations, and policies pertaining to access offerings.They will demonstrate a strong sense of urgency and self-motivation, ensuring successful achievement of company goals and objectives through clear and concise written/verbal communication. They will be a strong cross-functional influencer with experience partnering across commercial, medical, clinical, and external stakeholder groups.They will be a true team player, with the ability to adapt to changing environments, balance competing priorities, and respond to ambiguity and unforeseen challenges with maturity, professionalism, and sound judgment.They will have extensive knowledge of laws and regulations that govern contracting and pricing for pharmaceutical products. They will have experience managing long-term enterprise-level relationships, and driving complex contract negotiations and contracts pull-through.They will have deep understanding and compliance with the OIG and FDA regulations governing pharmaceutical marketing and the PhRMA code. They will have excellent communication skills with stakeholders at all levels of the organization; possessing a persuasive and credible presentation style.Preferred skills include launch experience, specifically of oral specialty drugs is highly valued; rare disease experience is a plus. Experience in and understanding of other commercial functions (e.g., marketing, market access, sales, insights/analytics, etc.) will be an important consideration for this role.The base compensation range for this role is: $185,000 - $215,000. Base salary offered is determined through an analytical approach utilizing a combination of factors including, but not limited to, relevant skills & experience, job location, and internal equity.

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