Reimbursement manager Jobs in Los Angeles, CA

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At Gilead, we’re creating a healthier world for all people. For more than 35 years, we’ve tackled diseases such as HIV, viral hepatitis, COVID-19 and cancer – working relentlessly to develop therapies that help improve lives and to ensure access to these therapies across the globe. We continue to fight against the world’s biggest health challenges, and our mission requires collaboration, determination and a relentless drive to make a difference.

Every member of Gilead’s team plays a critical role in the discovery and development of life-changing scientific innovations. Our employees are our greatest asset as we work to achieve our bold ambitions, and we’re looking for the next wave of passionate and ambitious people ready to make a direct impact.

We believe every employee deserves a great leader. People Leaders are the cornerstone to the employee experience at Gilead and Kite. As a people leader now or in the future, you are the key driver in evolving our culture and creating an environment where every employee feels included, developed and empowered to fulfil their aspirations. Join Gilead and help create possible, together.

Job Description

Gilead's mission is to discover, develop, and deliver therapies that will improve the lives of patients with life-threatening illnesses worldwide. The Sr. Field Reimbursement Manager – HIV Prevention ( Sr. FRM) plays a critical role in enhancing patient access to Gilead’s HIV treatments by supporting healthcare providers (HCPs), patients, and stakeholders in navigating the complexities of the healthcare system. The Sr. FRM HIV Prevention will provide in-person and virtual training on access and reimbursement topics, including Gilead support programs, payer policies, prior authorization processes, and claims submissions, ensuring that HCPs and their staff have the necessary tools to facilitate patient access.

As an expert in HIV Prevention market access, the Sr. FRM – HIV Prevention will remain informed about local and national payer policies and acquisition pathways, proactively addressing coverage and reimbursement challenges to ensure timely treatment access. Collaboration with internal teams, including Therapeutic Specialists (Sales), Marketing, Account Management, and Patient Support, will be essential for aligning patient access strategies across the organization. The Sr. FRM – HIV Prevention will also engage in problem-solving to manage multiple projects and continuously identify opportunities for improving workflows, ultimately helping patients receive the necessary treatments without unnecessary delays.

This is a field-based role supporting the Los Angeles, CA area ; candidates must be able to travel 50% of the time with overnights included and reside within 10 miles of their region’s borders.

Specific job responsibilities :

Develop and manage business relationships with office staff at key accounts, including providers and specialty pharmacies, to facilitate patient access to Gilead’s products.

Serve as a local access and reimbursement expert, on access and reimbursement policies, processes, and practices, providing strategic education and support to internal and external stakeholders to drive successful access and reimbursement outcomes.

Assist the internal patient support program team in enhancing hub and FRM processes, such as streamlining benefit verification and improving education on prior authorizations to expedite patient treatment initiation.Oversee processes for providers to enroll patients in Gilead patient support programs. Work directly with case managers to resolve complex patient access questions in a timely manner.

Communicate changes in formulary or reimbursement processes for Gilead products, ensuring accounts receive timely support and education on requirements like medical exceptions and prior authorization.

Excel at collaborating with cross-functional internal and external stakeholders to create instructional resources that help providers and office staff understand best practices in reimbursement processes.

Increase coordination with the Gilead HUB to enhance communication channels between FRMs and case managers, providing efficient support to accounts.

Identify bottlenecks in the prescription journey that hinder therapy application and utilize technology tools to respond promptly to high-need cases.

Demonstrates open-mindedness and flexibility, being aware of cultural similarities and differences without assigning value, guiding the team to adapt to different environments and practices without being overly prescriptive.

Embodies a collaborative approach wholly dedicated to ensuring individual patient access and positive outcomes through teamwork, placing the individual who may need or benefit from PrEPand team success at the forefront.

Basic Qualifications :

• Bachelor's Degree and Eight Years’ Experience
• Masters' Degree and Six Years’ Experience
• Ph.D.

Preferred Qualifications :

BA / BS / RN with 8+ years of experience working for a major pharmaceutical organization on the field reimbursement team.

MA / MS / PharmD with 6+ years of experience working for a major pharmaceutical organization on the field reimbursement team.

Prior leadership experience is strongly preferred.

Deep understanding of the relationship between payers, providers, and pharma companies in reimbursement.

Experience engaging with and managing large, complex provider accounts.

Familiarity with pharmacy benefits, specialty payer landscape, and reimbursement pathways (commercial, Medicare, Medicaid).

An understanding of local and state policy changes' effect on reimbursement policies.

Preferably have experience with specialty pharmacies and utilizing a HUB service

A willingness to travel 75% of the time across designated regions.

This is a field-based role where in-person meetings with key stakeholders are crucial to success.

The salary range for this position is : $150,535.00 - $194,810.00. Gilead considers a variety of factors when determining base compensation, including experience, qualifications, and geographic location. These considerations mean actual compensation will vary. This position may also be eligible for a discretionary annual bonus, discretionary stock-based long-term incentives (eligibility may vary based on role), paid time off, and a benefits package. Benefits include company-sponsored medical, dental, vision, and life insurance plans

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For Current Gilead Employees and Contractors :

Please log onto your Internal Career Site (!CK5mGhIKBggDEMenAhIICgYI1A0QtgI~ / cacheable-task / 2997$2151.htmld#backheader=true) to apply for this job.

Gilead Sciences, Inc. is a biopharmaceutical company that has pursued and achieved breakthroughs in medicine for more than three decades, with the goal of creating a healthier world for all people. The company is committed to advancing innovative medicines to prevent and treat life-threatening diseases, including HIV, viral hepatitis and cancer. Gilead operates in more than 35 countries worldwide, with headquarters in Foster City, California.