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Associate Director, Field Reimbursement
3 months ago
AD, Access & Reimbursement - Prostate Cancer Product.
Location: Remote/or within a reasonable daily commuting distance of 60 miles from territory border.
Territory: Boise, ID Las Vegas & Reno, Nevada. Salt Lake City, UT
The Associate Director, Access & Reimbursement, The successful candidate must reside within territory, or within a reasonable daily commuting distance of 60 miles from territory border.
You will serve as the access and reimbursement lead in business-to-business conversations with account executives. The role is responsible for managing the pull-through of access and reimbursement strategy and downstream operations within their aligned accounts. You are expected to have deep expertise in communicating requirements and addressing barriers associated with local payer policy coverage, multi-channel acquisition pathways, billing, and coding (as needed), claims processing, reimbursement, and integration of manufacturer support programs into a range of account workflows.
Key Responsibilities:
Buy and Bill Specific
Assess access situation within the assigned geography and develop appropriate Plan of Action (POA). Communicate POA to appropriate personnel.Responsible for establishing preferred acquisition pathways. Educate on and support buy-and-bill end-to-end processes, workflows, and facility pull-through in complex accounts, including scenarios of centralized and decentralized acquisition, and use of alternative channels such as white bagging, clear bagging, brown bagging, and alternate site of care for administration.Educates relevant stakeholders on logistics related to ordering, payment, inventory, and product returns & replacement.Analyze reimbursement issues & opportunities, anticipating changes in the healthcare landscape, and act as the designated reimbursement expert for offices and field teams.Accountable for engagement with non-prescribers, for example pharmacy, system leadership, financial counsellors, office administrators, revenue cycle managers, etc.Essential Requirements:
5+ Years of experience in pharmaceuticals / biotech industry focused on Patient Services, Market Access, Sales, and/or account management. With 2 of those years being in a Patient Services practice support role for a specialty product(s).Experience working with highly complex practices and/or health systems to establish access and acquisition pathways.Strategic account management experience using a proactive approach to anticipate access hurdles impacting accounts and patient access.Deep expertise and experience integrating manufacturer-sponsored patient support programs.Experience with specialty products acquired through Specialty Pharmacy networks.Knowledge of reimbursement pathways (specialty pharmacy, buy-and-bill, retail)Possess a strong understanding of Commercial payers, Medicare plans and state Medicaid in geographic region.Must live within assigned territory; Ability to travel and cover geography, at least 50% travel required, based on geography and territory / targeting make up.Desirable Requirements:
Experience leading and delivering presentations to C-level account executives.Strong ability to work cross functionally with such functions as Field Sales, Marketing, Market Access, Public Affairs, State & Government Affairs, Trade, Specialty Pharmacy Account Management, and applicable third-party affiliates.Expertise in therapeutic area practice dynamics and common reimbursement and product program support-related needs. Such as Oncology, Prostate Cancer, or Nuclear MedicinesStrong capabilities in the areas of customer focus, collaboration, business acumen, communication, and presentation skills.
For more information, apply directly or e-mail j.hanas@proclinical.com
