Access and Reimbursement Manager – N Illinois, Wisconsin, Minneapolis

This is a fully remote position, open to applicants in Illinois, +2 more states.

📋 Description

• Assist in developing and sustaining treatment access for patients throughout their therapy journey.

• Spearhead the pull-through process for open cases by implementing compliant actions that enhance access and accelerate treatment initiation.

• Collaborate directly with prescribing offices, designated Specialty Pharmacies, the Patient Service Center, and sales team members.

• Analyze payer trends, inform business partners, and create, coordinate, and execute strategic plans to establish and preserve treatment access.

• Educate colleagues on the legal and regulatory frameworks associated with anti-kickback laws, fraud and abuse, off-label promotion, and OIG guidelines for patient assistance programs.

• Prioritize business requirements, address complex challenges, cultivate customer relationships, and inspire appropriate actions to advance cases.

• Adapt to shifting and evolving business demands.

⛳️ Requirements

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

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

• Strong comprehension of insurance and benefit design for 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.

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

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

• Proven track record in supporting and training HCP offices on best practices that streamline authorization and enhance treatment access.

• Experience liaising with Specialty Pharmacies to optimize processing times and facilitate shipment scheduling.

• Demonstrated skills in analysis, problem-solving, and relationship-building.

• Excellent communication, organizational, and leadership skills.

• Customer interaction and field travel requirements of up to 60%; overnight travel may be necessary depending on location.

• A Bachelor’s degree or higher is required.

🏝️ Benefits

• Competitive salary and benefits.

• Comprehensive Total Rewards package.

• Eligibility for bonuses in accordance with the applicable program.