Reimbursement Business Advisor, Botox

3 weeks ago

Lansing, Michigan, United States AbbVie Full time

Company Description

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 Follow @abbvie onTwitter,Facebook,Instagram,YouTubeandLinkedIn.
Job Description

Talent will be hired at a level commensurate with experience.

The Reimbursement Business Advisor (RBA) shares expertise and educates on 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 RBA clarifies barriers that may impede or delay appropriate patient access to treatment and/or prevent optimal patient outcomes. The RBA may interact with healthcare providers, administrative staff, revenue cycle management, and institutional leadership.

After the patient has been identified by an ABS provider, the RBA offers approved tools and standardization methods to provide reimbursement and technical knowledge to gain patient access while reducing access challenges.

Responsibilities

Educate on the fundamentals of the BOTOX treatment process, appropriate reimbursement, and understanding the payer landscapeLeverages advance problem-solving and analytical skills to identify access and reimbursement barriers while offering actionable insights to desired and approved careUncover the root cause to access issues impeding or delaying proper treatmentMonitor and provide updates on both Region and National Payers. Examples include changes or barriers in medical policy, Prior Authorization requirements, or product acquisition. Apply compliant methods to exchange critical informationWork collaboratively and function as a liaison for information between various internal stakeholders such as: Market Access, Center of Excellence, Sales, Marketing, Training, Compliance, Trade, and Specialty Pharmacy groups.Provide customer feedback relating to approval requirements and access to care barriers with AbbVie stakeholders (Market Access, Center of Excellence, Sales, Marketing, Trade, Specialty Pharmacy, Senior Leadership)Educate accounts on need-based tools to support patient access. Examples include HUB services, patient savings programs, payer coverage details, and acquisition pull-through initiativesProficient in providing analytical and customized need-based solutions to problems in complex environments and matrix influenced health systems and practicesEstablish and maintain respectful working relationships with healthcare professionals and staff as well as business-oriented decision makers including C-Suite level executives within territoryDemonstrates the ability to lead without authority and effectively communicate with diverse groups with sometimes different prioritiesCapable of influencing across functions to gain consensus on agreed upon patient solutionsAbility to professionally deliver crucial conversations that may contain less than desirable information or factsProactively engage in Field Input Teams offering innovative solutions to problems in a fast-paced changing environmentShare customer challenges and suggest potential solutions to address obstaclesDemonstrate effective planning, prioritization, follow up, and anticipates problemsThe employee conducts all work activities in compliance with all Abbvie internal requirements and with all applicable regulatory requirementsContinuous 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
A minimum of 57 years of proven success in a health care related fieldBachelors degree requiredPreferred experience includes Previous Sales, District Management, Hospital, Managed Markets, Access and Reimbursement, or practice experienceKnowledge of Lean Six Sigma principles is favorableExposure to physician-administered injectables, CPT and/or J-code reimbursement, Specialty Pharmacy and Buy & Bill acquisition, Benefit Verifications, Prior Authorizations, Claim Assistance, Appeals and payor policies, and HUB servicesProven record of comprehensive work with accounts at all levelsPayer/insurance coverage experience with Medicare, Medicare Advantage, Commercial and Medicaid plansWell-developed verbal and written communication skills, including in-person and virtual presentation skills of complex information and processesProven and consistent competence of the following skills: Problem Solving, Gain Access, Resource Mastery, Tangible Results, Overcoming Adversity, Collaboration, and Managing ComplexitiesDemonstration of key soft skills: Empathy, Critical Thinking, Curiosity, Persistence, Reliability, and ResourcefulnessStrong history of leadership within current roleTechnology and analytical skills (Salesforce, virtual meetings, excel, report interpretation)A Valid Drivers LicenseAbility to travel adequately to cover territory, attend training, and meetings. Some overnight travel may be required
Additional Information
Applicable only to applicants applying to a position in any location with pay disclosure requirements under state orlocal law: The compensation range described below is the range of possible base pay compensation that the Companybelieves ingood faith it will pay for this role at the timeof this posting based on the job grade for this position.Individualcompensation paid within this range will depend on many factors including geographic location, andwemay ultimatelypay more or less than the posted range. This range may be modified in thefuture. We offer a comprehensive package of benefits including paid time off (vacation, holidays, sick),medical/dental/visioninsurance and 401(k) to eligibleemployees. This job is eligible to participate in our short-term incentiveprograms. This job is eligible to participate in our long-term incentiveprograms Note: No amount of payis considered to bewages or compensation until such amount is earned, vested, anddeterminable.The amount and availability of any bonus,commission, incentive, benefits, or any other form ofcompensation and benefitsthat are allocable to a particular employee remains in the Company's sole andabsolutediscretion unless and until paid andmay be modified at the Companys sole and absolute discretion, consistent withapplicable law. AbbVie is an equal opportunity employer and is committed to operating with integrity, driving innovation, transforming lives, serving our community and embracing diversity and inclusion. It is AbbVies 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. US & Puerto Rico only - to learn more, visit

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