I & I Access and Reimbursement Regional Director

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

📋 Description

• Directly oversee and provide strategic guidance, daily management, compliance supervision, and performance evaluation for regional Field Reimbursement Managers.

• Supervise the execution of FRM initiatives, including patient needs assessments, reimbursement navigation, healthcare professional office education, clarification of payer policies, optimization of account workflows, and support for hub enrollment.

• Establish and enforce performance standards aligned with national KPIs.

• Conduct field visits, call coaching sessions, performance assessments, and discussions for individual development.

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

• Manage the regional budget, headcount strategy, travel expenditures, and program resources.

• Mentor FRMs on comprehensive patient journey leadership, identifying barriers, escalation processes, enrollment, therapy initiation, and continuation.

• Monitor and address patient access challenges, including prior authorization delays, step edits, gaps in coding/documentation, affordability issues, coverage inconsistencies, specialty pharmacy fulfillment problems, and enrollment drop-offs.

• Act as an escalation resource for complicated patient access scenarios.

• Develop team expertise in reimbursement across payer landscapes, coverage pathways, prior authorizations, appeals, coding, claims, medical and pharmacy benefits, and payer-specific requirements.

• Identify trends in payer policy, coverage gaps, formulary modifications, documentation prerequisites, and reimbursement challenges; share insights internally.

• Collaborate with market access, trade, and HEOR teams on national account strategies.

• Set standards for compliant education for healthcare professionals and office staff.

• Spearhead regional account-level access strategies and scalable solutions for workflow challenges across priority accounts, group practices, IDNs, and academic medical centers.

• Coordinate regional access leadership across 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.

• Aggregate FRM insights on payer trends, reimbursement difficulties, HCP workflow challenges, account dynamics, and access delays into actionable recommendations.

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

• Utilize field data, team observations, and market access intelligence to inform coaching, account strategy, escalation pathways, and ongoing improvements.

• Ensure team compliance with Pfizer policies, OIG guidelines, PhRMA Code, federal and state regulations, and necessary compliance training.

⛳️ Requirements

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

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

• 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 is essential.

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

• Strong understanding of the access and reimbursement landscape, including benefits investigation, prior authorization, step edits, appeals, payer policy, coverage pathways, specialty pharmacy fulfillment, and insurance coverage processes is required.

• 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 is essential.

• 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 is required.

• Demonstrated capacity to lead by influence across cross-functional teams is essential.

• Experience managing a large geographic territory and willingness to travel 50–60% of the time is necessary.

• A valid U.S. driver's license and a driving record that meets company standards; any DUI/DWI or impaired driving citation within the past 7 years will disqualify hiring.

• Experience in immunology & inflammation or rare disease therapeutic areas is preferred.

• Familiarity with Pfizer hub infrastructure is preferred.

• Previous experience leading Access and Reimbursement, patient access, hub operations, field reimbursement, or hybrid patient/HCP access support roles is preferred.

• A history of improving enrollment metrics or time-to-therapy outcomes is preferred.

• Established relationships with regional payer medical directors, pharmacy directors, or key account decision-makers are preferred.

• Experience with product launches in access and reimbursement is preferred.

• Experience leading through ambiguity in highly regulated, cross-functional environments is preferred.

• Preferred candidates will reside within the Region.

• Must live near an airport, travel within the Region, and reside within the Region.

• Candidates must be authorized to work in the U.S. for any employer.

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

• Requires permanent work authorization in the United States.

🏝️ Benefits

• Pfizer Global Performance Plan with a 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.