Access and Reimbursement Manager (N Illinois/Wisconsin/Minneapolis)
About The Position
The Access and Reimbursement Manager helps create and maintain patient access to treatment throughout the course of therapy. While sales specialists drive new business demand, the manager leads case pull-through by taking compliant actions that improve access and expedite patients’ treatment starts. The role works directly with prescribing offices, contracted Specialty Pharmacies, the Patient Service Center, and sales colleagues. The manager identifies payer trends, alerts business partners, and develops, coordinates, and executes tactical plans to create and maintain treatment access. As an access expert and leader, the manager serves as a valuable resource to colleagues and customers. The role requires consistently demonstrating ethics and integrity and helping others understand legal and regulatory parameters concerning anti-kickback statutes, fraud and abuse, off-label promotion, and OIG guidance related to patient assistance programs. The position suits someone who can prioritize business needs, solve complex problems, build customer relationships, motivate others to move cases forward, and adapt quickly to changing business needs. It includes customer interaction and field travel of up to 60%, with overnight travel dependent on geography. The position is based in Chicago, Illinois, with additional locations in Milwaukee, Wisconsin, and Minneapolis, Minnesota.
Requirements
- At least 5 years of experience working with specialty pharmaceutical products, or at least 2 years in an access-related position outside of pharma.
- Strong understanding of insurance and benefit design with commercial and government payers.
- Experience navigating complex authorization processes for specialty medications.
- Experience working with a Patient Service Center or Hub to design case-specific strategies based on payer mix, benefit design, and authorization requirements.
- Demonstrated analytical, problem-solving, and relationship-building skills.
- Excellent communication, organizational, and leadership skills.
- Bachelor’s degree or higher required.
- Ability to travel in the field up to 60%; overnight travel depends on geography.
Nice To Haves
- Experience in one or more of the following therapeutic areas: Ophthalmology, Nephrology, Rheumatology, Pulmonology, Neurology, or Dermatology.
- Background in Access & Reimbursement, payer account management, Specialty Pharmacy distribution, Patient Services, or Case Management.
Responsibilities
- Lead case pull-through by taking compliant actions that improve access and expedite patients’ starts to treatment.
- Work directly with prescribing offices, contracted Specialty Pharmacies, the Patient Service Center, and sales colleagues.
- Identify payer trends, alert business partners, and develop, coordinate, and execute tactical plans to create and maintain treatment access.
- Help colleagues understand legal and regulatory parameters related to anti-kickback statutes, fraud and abuse, off-label promotion, and OIG guidance on patient assistance programs.
- Support and educate healthcare provider offices on best practices that streamline authorization and expedite patient access.
- Coordinate case pull-through with the Patient Service Center, Case Managers, Sales, and Specialty Pharmacies.
- Communicate with Specialty Pharmacies to improve processing time and facilitate shipment scheduling.
Benefits
- Competitive pay and benefits as part of a Total Rewards package.
- Eligibility for a bonus in accordance with the terms of the applicable program; bonuses are awarded at the Company’s discretion.
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What This Job Offers
Job Type
Full-time
