Access and Reimbursement Manager – Neph Overlay

This is a fully remote position, open to applicants in Arizona, +1 more state.

📋 Description

• Establish and uphold 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 patients' initiation of treatment.

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

• Recognize payer trends and notify business partners accordingly.

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

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

• Prioritize business requirements, resolve intricate issues, foster customer relationships, and inspire appropriate actions to advance cases.

• Support and educate healthcare provider (HCP) offices on practices that optimize authorization processes and expedite treatment access.

• Engage with specialty pharmacies to enhance processing times and facilitate shipment scheduling.

⛳️ Requirements

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

• Preferred experience in one or more of the following fields: Ophthalmology, Nephrology, Rheumatology, Pulmonology, Neurology, Dermatology.

• Strong comprehension 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 develop case-specific strategies based on payer mix, benefit design, and authorization requirements.

• Skilled 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 for authorization processes.

• Experience in communicating with specialty pharmacies to enhance processing times and facilitate shipment scheduling.

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

• Exceptional communication, organizational, and leadership skills.

• Willingness to engage in customer interaction and field travel up to 60%, with overnight stays depending on geography.

• A Bachelor's degree or higher is required.

🏝️ Benefits

• Competitive salary and benefits package.

• Eligibility for bonuses based on the terms of the applicable program.