Access and Reimbursement Regional Director, Central

This is a fully remote position, open to applicants in Illinois, +4 more states.

📋 Description

• Provide strategic direction, daily oversight, compliance management, and performance evaluation for regional Field Reimbursement Managers.

• Supervise patient needs assessments, reimbursement navigation, healthcare provider office education, payer policy clarification, account workflow enhancement, and hub enrollment assistance.

• Establish and uphold performance standards aligned with national key performance indicators (KPIs).

• Conduct field rides, call coaching sessions, performance evaluations, and personalized development discussions.

• Lead the recruitment, onboarding, and performance management processes for the regional FRM team.

• Oversee the regional budget, including headcount planning, travel expenses, and program resources.

• Mentor FRMs on comprehensive patient journey management from needs assessment and enrollment through therapy initiation, continuation, and case resolution.

• Monitor and resolve prior authorization delays, step edits, coding or documentation discrepancies, affordability issues, coverage gaps, specialty pharmacy fulfillment challenges, and enrollment drop-offs.

• Act as an escalation point for complex patient access scenarios.

• Cultivate team proficiency in reimbursement across payer landscapes, coverage pathways, appeals, coding, claims, and both medical and pharmacy benefits.

• Identify payer policy trends, coverage issues, formulary modifications, documentation needs, and reimbursement obstacles.

• Collaborate with Market Access, Trade, and HEOR teams on national account strategies.

• Establish standards for compliant education for healthcare providers and office staff.

• Drive regional account-level access strategies and enhance efficiency across key accounts and practices.

• Coordinate regional access leadership in collaboration with Brand, National Access & Reimbursement, Field Sales, Key Account Directors, Patient Solutions, Hub partners, Legal/Compliance, and Market Access.

• Track, analyze, and report regional performance metrics to the National Lead.

• Compile regional insights and convert them into actionable recommendations.

• Ensure prompt and accurate documentation of patient interactions and case activities.

• Monitor team activities and documentation to ensure compliance and completion of required training.

⛳️ Requirements

• A bachelor's degree is required; an advanced degree (MBA, MPH, PharmD) is preferred.

• A minimum of 10 years of experience in pharmaceutical field operations, patient services, reimbursement, or access/hub management.

• At least 3–5+ years of experience in people management, leading, coaching, or developing field-based access, reimbursement, patient services, hub-facing, or customer-facing teams.

• Direct experience with specialty pharmacy, hub programs, or patient support services in a regulated environment.

• Strong knowledge of benefits investigation, prior authorization, step edits, appeals, payer policy, coverage pathways, specialty pharmacy fulfillment, and insurance coverage processes.

• Familiarity with medical and pharmacy billing, including CPT, HCPCS/J-codes, ICD-10, NDC, Medicare Part B buy-and-bill, specialty pharmacy processes, and payer-specific coverage criteria relevant to INI/specialty products.

• Proven ability to develop reimbursement subject matter expertise within a team and translate payer policy, patient access data, and field insights into regional action plans.

• Demonstrated capability to lead through influence across cross-functional teams.

• Proven track record of managing a large geographic territory and willingness to travel 50–60% of the time.

• A valid U.S. driver’s license and a driving record that meets company standards; any DUI/DWI or other impaired driving citations within the past 7 years disqualifies hiring.

• Preferred: experience in immunology and infectious disease or rare disease therapeutic areas.

• Preferred: familiarity with Pfizer hub infrastructure, such as PDPA or equivalent specialty pharmacy program.

• Preferred: previous experience in leading Access and Reimbursement, patient access, hub operations, field reimbursement, or hybrid patient/HCP access support roles.

• Preferred: a history of improving enrollment metrics or time-to-therapy outcomes.

• Preferred: existing relationships with regional payer medical directors, pharmacy directors, or key account decision-makers.

• Preferred: experience with product launches related to access and reimbursement.

• Preferred: experience in navigating ambiguity in highly regulated, cross-functional environments.

• Must reside within the region.

• Must live near an airport, be able to travel within the region, and maintain residence within the region.

• Candidates must have authorization to work in the U.S. for any employer.

• U.S. work visa sponsorship is not available now or in the future.

• Permanent work authorization in the United States is required.

🏝️ Benefits

• Global Performance Plan bonus target of 22.5% of base salary.

• Share-based long-term incentive program.

• 401(k) plan with Pfizer matching contributions.

• Additional Pfizer Retirement Savings Contribution.

• Paid vacation, holidays, and personal days.

• Paid caregiver/parental and medical leave.

• Medical, prescription drug, dental, and vision coverage.

• Relocation assistance may be available based on business needs and/or eligibility.