Reimbursement Navigator

This is a fully remote position, open to applicants in California.

📋 Description

• Enhance patient access and reimbursement through authorized education, support for reimbursement, and execution of approved activities.

• Provide education to healthcare providers, office personnel, and authorized matrix partners regarding reimbursement procedures, coverage pathways, financial assistance programs, and sanctioned patient support services.

• Assess intricate reimbursement and access challenges and create effective strategies to facilitate patient access while adhering to approved policies and compliance guidelines.

• Collaborate with the HUB, specialty pharmacy, and approved partners to assist with patient enrollment, benefits investigations, prior authorizations, appeals, denied claims, and reimbursement-related case management.

• Act as the local expert on reimbursement and access for Sales, Market Access, and regional leadership.

• Formulate and implement strategic territory plans alongside internal and external stakeholders to enhance patient access and customer support.

• Foster and sustain collaborative relationships with healthcare providers, office personnel, specialty pharmacies, patient support partners, and internal cross-functional teams.

• Actively identify reimbursement obstacles and deploy compliant solutions that enhance patient access and customer experience.

• Maintain documentation of customer interactions and ensure accuracy within approved company systems.

• Operate in strict compliance with all company policies, legal, regulatory, privacy, and compliance standards.

• Oversee business travel and expenses in accordance with established company guidelines.

⛳️ Requirements

• A bachelor's degree is required; a background in healthcare, life sciences, nursing, or a related field is preferred.

• At least seven (7) years of experience in the pharmaceutical and/or biotechnology industry.

• A minimum of three (3) years of experience in one or more of the following areas:

• Field reimbursement

• Patient access and reimbursement

• Specialty medication access solutions

• Specialty pharmacy

• Advanced specialty pharmaceutical sales

• Patient support services

• Proven knowledge of pharmacy benefit reimbursement.

• Demonstrated capability to analyze and resolve complex reimbursement and patient access issues.

• Strong comprehension of specialty pharmacy operations and patient support services.

• Must reside within the designated territory or its boundaries.

• A valid driver's license with the capacity to travel extensively within the assigned territory.

🏝️ Benefits

• Competitive salaries and an exceptional benefits package.