Access and Reimbursement Manager

This is a fully remote position, open to applicants in California.

📋 Description

• Establish and uphold treatment access for patients throughout their therapy journey.

• Direct the case pull-through process by undertaking compliant actions that enhance access and accelerate the initiation of patient treatments.

• Collaborate closely with prescribing offices, contracted Specialty Pharmacies, the Patient Service Center, and sales teams.

• Analyze payer trends and inform business partners accordingly.

• Design, coordinate, and implement tactical strategies to ensure the creation and maintenance of treatment access.

• Assist colleagues in understanding the legal and regulatory frameworks concerning anti-kickback statutes, fraud and abuse, off-label promotion, and OIG guidance related to patient assistance programs.

• Prioritize business requirements, resolve intricate issues, foster customer relationships, and motivate stakeholders to advance cases.

⛳️ Requirements

• A minimum of 5 years of experience with specialty pharmaceutical products, or at least 2 years in an access-related role outside of the pharmaceutical industry.

• Preferred experience in Ophthalmology, Nephrology, Rheumatology, Pulmonology, Neurology, or Dermatology.

• Comprehensive understanding of insurance and benefit design involving both commercial and government payers.

• Background in Access & Reimbursement, Payer account management, Specialty Pharmacy distribution, Patient Services, or Case Management.

• Proven ability to navigate complex authorization processes for specialty medications successfully.

• Experience collaborating with a Patient Service Center/Hub to create case-specific strategies based on payer mix, benefit design, and authorization criteria.

• Experience in coordinating case pull-through with the Patient Service Center, Case Managers, Sales, and Specialty Pharmacies.

• Field responsibilities include supporting and educating HCP offices on best practices that facilitate authorization and expedite treatment access.

• Experience communicating with Specialty Pharmacies to enhance processing time and assist in shipment scheduling.

• Proven analytical, problem-solving, and relationship-building capabilities.

• Exceptional communication, organizational, and leadership skills.

• Customer interaction and field travel up to 60%; overnight stays may be required based on location.

• A Bachelor’s degree or higher is mandatory.

🏝️ Benefits

• Competitive salary and benefits package.

• Comprehensive Total Rewards program.

• Eligibility for bonuses in accordance with the applicable program.