Access and Reimbursement Manager (Phoenix / Tucson)

Access And Reimbursement Manager (Phoenix / Tucson)

The primary responsibility of the Access And Reimbursement Manager is to help create and maintain treatment access for patients through the duration of the course of therapy. While the sales specialist drives new business demand, the Access And Reimbursement Manager leads the "pull-through" process on open cases by taking compliant actions that improve access and expedite a patient's start to treatment. The Access And Reimbursement Manager facilitates this process by working directly with prescribing offices, contracted Specialty Pharmacies, the Patient Service Center, and sales colleagues.

In addition to leading case "pull-through", the Access And Reimbursement Manager also identifies payer trends, alerts business partners, and takes initiative around developing, coordinating and executing tactical plans in order to create and maintain treatment access for patients. Due to the Access And Reimbursement Manager's leadership and access expertise, this individual is viewed by colleagues and customers as a valuable resource that plays a critical role in their success.

The Access And Reimbursement Manager consistently demonstrates uncompromised ethics and integrity while helping others understand legal and regulatory parameters related to anti-kickback statutes, fraud and abuse, off-label promotion, and OIG guidance related to patient assistance programs.

The ideal candidate enjoys working in a fast-paced environment and has the ability to prioritize business needs, solve complex problems, develop strong customer relationships, and motivate others to take appropriate action to move cases forward. The Access And Reimbursement Manager needs to quickly and successfully adapt to evolving and changing business needs.

Preferred Experience and Qualifications :

• Minimum of 5 years' experience working with specialty pharmaceutical products, or minimum of 2 years' access-related position outside of pharma
• Experience preferred in one or more of the following areas :
• Ophthalmology
• Nephrology
• Rheumatology
• Pulmonology
• Neurology
• Dermatology
• Strong understanding of insurance and benefit design with both commercial and government payers
• Background in Access & Reimbursement, Payer account management, Specialty Pharmacy distribution, Patient Services, Case Management
• Successful navigation of complex authorization processes for specialty medications
• Working with a Patient Service Center / Hub in order to design case-specific strategies based on payer mix, benefit design, and authorization requirements.
• Coordinating case pull-through with the Patient Service Center, Case Managers, Sales, and Specialty Pharmacies
• Supporting and educating HCP offices on best practices that streamline the authorization process and expedite treatment access for patients
• Communicating with SPs to improve processing time and help facilitate shipment scheduling
• Demonstrated analytical, problem solving, and relationship-building skills
• Excellent communication, organizational and leadership skills
• Customer interaction and field travel up to 60% - overnights dependent on geography
• Preferred Location : Phoenix, AZ or Tucson, AZ

Bachelor's or higher degree required