Director, Reimbursement Business Advisor

2 weeks ago

Denver, Colorado, United States AbbVie Full time


AbbVie's mission is to discover and deliver innovative medicines and solutions that solve serious health issues today and address the medical challenges of tomorrow.

We strive to have a remarkable impact on people's lives across several key therapeutic areas – immunology, oncology, neuroscience, and eye care – and products and services in our Allergan Aesthetics portfolio.

For more information about AbbVie, please visit us at Follow @abbvie on Twitter, Facebook, Instagram, YouTube and LinkedIn.
Job Description

The Director of Reimbursement Business Advisor (DRBA) leads a field team of Reimbursement Business Advisors (RBA) to ensure patients have access to our medications by educating customers on payor policy, medical documentation requirements, and product acquisition.

This role oversees strategic direction, operations, and performance of the RBA Team while supporting Abbvie Patient Services initiatives.

The DRBA primary role is working with RBAs to ensure customers are knowledgeable about key areas of patient access including: Medical and Pharmacy benefits, Buy & Bill and Specialty Pharmacy acquisition, payor policy, appropriate patient identification, clinical documentation, benefit investigation results, prior authorizations, billing, coding, patient tracking, claim submission, reconciliation management, patient financial savings programs, patient tracking/retreatment, and the denial/appeal process for the approved indications for BOTOX Therapeutics.

The DRBA is responsible for developing, implementing , and monitoring compliant solutions to access to care challenges, providing feedback on payor landscape related issues, and continuous people development.


Responsibilities:
Demonstrate commitment to talent development, the value of diversity, and high level of performance standards with the Abbvie Ways We Work
Provide an inspiring culture of reimbursement expertise, collaboration, empowerment, and patient support
Hire, coach, and develop team members to identify, educate, and evaluate tools that impact patient access to care and provider reimbursement
Compliantly collaborate with cross-functional teams including Market Access, Sales, Marketing, Trade, and other Patient Support teams and customer groups
Ascertain information regarding payor trends, healthcare policy, and government regulations pertinent to access to patient care
Establish key performance indicators and level of impact to monitor the effectiveness of the RBA Team, removal of coverage barriers, and tailored customer support
Contribute to the development of evolutionary provider services that allow for streamlined approaches to access to prescribed medicines
Analyze data and metrics to identify trends, opportunities, and areas for improvement in patient access and reimbursement processes
Lead internal field input teams to maximize the voice of the customer and patient
Oversee all work activities in compliance with all Abbvie internal requirements and with all applicable regulatory requirements
Continuous sitting for prolonged periods (more than 2 consecutive hours in an 8 hr day) is required
Driving a personal auto or company car or truck, or a powered piece of material handling equipment
Qualifications

Bachelor's degree required:
MBA or advanced degree preferred
Minimum of 10 years of professional experience in a health care related field
Minimum of 3 years of people leadership, achieving strategic objectives, and driving results in a complex market space

Preferred previous positions include:
Previous Sales, District Management, Market Access, Access and Reimbursement, and Product Marketing

Preferred knowledge base include:
physician-administered injectables, CPT and/or J-code reimbursement, Specialty Pharmacy and Buy & Bill acquisition, Benefit Verifications, Prior Authorizations, Claim Assistance, Appeals, Denials, patient savings programs, and HUB services
Experience engaging with large-scale complex hospital and provider accounts
Proficiency in working in matrix environments across all internal stakeholders
Deep understanding of payer and benefit design as well as reimbursement process for Commercial, Medicare Advantage, and Medicaid plans
Well-developed verbal and written communication skills, data analytic, project management and corporate objectives implementation
Knowledge of Lean Six Sigma principles
Valid Drivers License
Ability to travel adequately to cover the region, attend training, and meetings. Up to 75% travel may be required
Additional Information
Applicable only to applicants applying to a position in any location with pay disclosure requirements under state or local law:

The compensation range described below is the range of possible base pay compensation that the Company believes in good faith it will pay for this role at the time of this posting based on the job grade for this position.

Individual compensation paid within this range will depend on many factors including geographic location, and we may ultimately pay more or less than the posted range.

This range may be modified in the future.

We offer a comprehensive package of benefits including paid time off (vacation, holidays, sick), medical/dental/vision insurance and 401(k) to eligible employees.

This job is eligible to participate in our short-term incentive programs.
This job is eligible to participate in our long-term incentive programs

Note:

No amount of pay is considered to be wages or compensation until such amount is earned, vested, and determinable.

The amount and availability of any bonus, commission, incentive, benefits, or any other form of compensation and benefits that are allocable to a particular employee remains in the Company's sole and absolute discretion unless and until paid and may be modified at the Company's sole and absolute discretion, consistent with applicable law.

AbbVie is committed to operating with integrity, driving innovation, transforming lives, serving our community and embracing diversity and inclusion.

It is AbbVie's policy to employ qualified persons of the greatest ability without discrimination against any employee or applicant for employment because of race, color, religion, national origin, age, sex (including pregnancy), physical or mental disability, medical condition, genetic information, gender identity or expression, sexual orientation, marital status, status as a protected veteran, or any other legally protected group status.

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