Field Reimbursement Manager

4 days ago

Palm Springs, United States GSK Full time

**Site Name**: USA - California - San Diego, USA - California - Palm Springs

**Posted Date**: May 28 2024

**Company Overview**

ViiV Healthcare is a global specialty HIV company, the only one that is 100% focused on researching and delivering new medicines for people living with, and at risk of, HIV. ViiV Healthcare is highly mission-driven in our unrelenting commitment to being a trusted partner for all people living with and affected by HIV. Our aim is to think, act, and connect differently through a focus on education on for the prevention and treatment for HIV. We go to extraordinary lengths to deliver the sorts of breakthroughs, both in prevention, treatments, care solutions and communities, that really count. We go beyond the boundaries of medicine by taking a holistic approach to HIV through developing and supporting sustainable community programs and improving access to care. We are fully committed to push through every challenge until HIV/AIDS is eradicated. ViiV Healthcare has played a significant part in delivering breakthroughs that have turned HIV into a manageable health condition. We offer the largest portfolio of HIV medicines available anywhere, and we continue our work to cater for the widest possible range of needs in response to the HIV epidemic.

We are aware of how much is at stake for those at-risk or affected by HIV and we show up every day 100% committed to the patients. Our work culture is fast-paced, diverse, inclusive, competitive, and caring. But ViiV Healthcare isn’t just somewhere to work - it’s a place to belong, an invitation to bring your very best, and a team full of impact-driven team members who are hungry to make a difference.

While we have been improving lives of HIV patients for 30 years, this is an especially exciting time to be at ViiV Healthcare, as we evaluate novel approaches to treatment and prevention that could further reduce the impact of HIV on individuals and communities.

**Job Details**

Are you energized by a highly visible role within the managed markets environment, that allows you to help fulfill our mission to leave no person living with HIV behind? If so, this Field Reimbursement Manager role could be an ideal opportunity to consider.

The Field Reimbursement Manager will provide external and internal reimbursement and access support for ViiV Healthcare (VHC) products within a specified geographic region.

This position is a customer-facing, field-based role responsible for supporting appropriate patient access to ViiV Healthcare products, including coverage coding and payment assistance. The FRM will:

- Educate providers about important product reimbursement information and processes across settings of care.
- Review key payer policies, coverage and authorization criteria with prescribing providers and their staff.
- Communicate ViiV Access Support Services that may be available to help appropriate patients access ViiV Healthcare medicines.
- Review acquisition options (specialty pharmacy and buy-and-bill) and potential implications to the facility/practice and patient.
- Compliantly discuss applicable coding necessary for claim submission (HCPCS, CPT, ICD-10, billable units).
- Act as the primary access and reimbursement resource for internal field counterparts.
- Work with colleagues across the business to assess the access landscape, changing insurance dynamics and patient journey.
- Lead regional matrix partner calls to review regional activity, access barriers and opportunities.
- Serve as an integral member of the ViiV field team with a primary focus on ensuring each appropriate patient leverage healthcare coverage and ViiV support programs to maximize access to ViiV Healthcare medicines.
- Engage Medicare Administrative Contractors to ensure appropriate coverage of VHC products.

**_ Why you?_**:
**Basic Qualifications**:

- We are looking for professionals with these required skills to achieve our goals:_
- Bachelor’s Degree
- Ability to travel up to 75% including overnights
- Must be located within 50 miles of a major airport in or near the territory
- Valid driver’s license.
- Minimum of 5 years’ experience in pharmaceutical and/or health care industry (must include experience in a specialty division) with at least 3 years in field reimbursement, payer marketing, patient support programs and/or reimbursement HUB programs.

**Preferred Qualifications**:

- If you have the following characteristics, it would be a plus_
- MBA, MPH or other advanced degree
- Strong knowledge of the payer environment including state, federal, private third-party reimbursement issues, methodologies and policies for physician-administered drugs
- Strong customer focus with building relationships, issue identification and resolution, problem-solving and project management skills
- Ability to operate independently and handle multiple projects with a high degree of initiative and operate successfully in matrix environment reporting into reimbursement

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