Access and Reimbursement Manager – N Illinois/Wisconsin/Minneapolis

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

📋 Description

• Develop and sustain treatment access for patients throughout their therapy journey.

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

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

• Recognize payer trends and inform business partners accordingly.

• Formulate, coordinate, and implement tactical plans to establish and sustain treatment access.

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

• Prioritize business objectives, address complex problems, cultivate customer relationships, and inspire colleagues to advance cases.

• Adapt to shifting and evolving business requirements.

⛳️ 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.

• Strong grasp of insurance and benefit design across 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 develop case-specific strategies based on payer mix, benefit design, and authorization requirements.

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

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

• Experience in communicating with Specialty Pharmacies to enhance processing times and coordinate shipment scheduling.

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

• Exceptional communication, organizational, and leadership skills.

• Up to 60% customer interaction and field travel; overnight stays may be required based on geography.

• A Bachelor’s degree or higher is mandatory.

🏝️ Benefits

• Competitive compensation and benefits package.

• Eligibility for bonuses according to the relevant program.