Access & Reimbursement Manager, Allergy

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

📋 Description

• Engage with designated accounts to enhance patient access within their therapeutic area products, offering proactive in-person education on product-specific programs to healthcare providers and staff, ensuring these programs are seamlessly integrated into office processes and workflows.

• Demonstrate the ability to analyze challenges and propose effective solutions.

• Comprehend details and address inquiries related to payer policies (such as utilization management, denials, and appeals), drug procurement and inventory control, and patient/practice reimbursement (including co-pay, administration, and drug claims).

• Assess account reimbursement challenges and opportunities as necessary.

• Recognize trends on a local, regional, and national scale and collaborate purposefully both internally and externally to enhance patient pull-through.

• Collaborate with the Patient Support Center (hub) on critical issues concerning patient case management, which includes monitoring cases, resolving issues, providing reimbursement support, and educating appropriate office staff.

• Review patient-specific details when assistance is explicitly requested by the site and when patient health information is accessible to resolve any issues or coverage obstacles.

• Work in partnership with aligned cross-functional associates within NPC (as previously mentioned) to exchange insights regarding customer needs and barriers related to access and reimbursement for their designated therapeutic area products.

• Maintain an in-depth understanding of NPC policies and requirements, fulfilling all responsibilities with integrity and in alignment with company guidance and established Values and Behaviors.

• Handle Patient Identifiable Information (PII) responsibly, ensuring compliance with HIPAA and other privacy laws, as well as internal company compliance protocols.

⛳️ Requirements

• A minimum of three to five years of experience in the public or private third-party reimbursement sector or pharmaceutical industry, particularly in managed care, clinical support, or sales.

• Familiarity with specialty pharmacy products obtained through specialty pharmacy networks or specialty distributors (buy and bill).

• Experience with coding, billing, and office support programs.

• Previous account management experience or experience handling complex accounts (including payer landscape, high patient volume, and large systems).

• Knowledge of Managed Care, Government, and Federal payer sectors, along with Integrated Delivery Networks/Integrated Health Systems.

• Proven ability to work collaboratively as a “team player” with multiple sales representatives, sales leadership, and internal colleagues to achieve shared objectives.

• Candidates must reside within the territory or within a reasonable daily commuting distance of X miles from the territory border.

• Willingness to travel 60-80% across a wide geographic area is required, with the capability to drive and/or fly within the territory.

• A valid driver’s license is mandatory.

🏝️ Benefits

• Health, life, and disability benefits.

• 401(k) plan with company contribution and matching.

• A generous time-off package that includes vacation, personal days, holidays, and other leaves.