Access and Reimbursement Manager (NYC Metro)
About The Position
The Access and Reimbursement Manager (ARM) helps create and maintain patient access to treatment throughout the course of therapy. While the sales specialist drives new business demand, the ARM leads the pull-through process for open cases by taking compliant actions that improve access and expedite patients’ starts of treatment. The role works directly with prescribing offices, contracted Specialty Pharmacies, the Patient Service Center, and sales colleagues. The ARM identifies payer trends, alerts business partners, and develops, coordinates, and executes tactical plans to create and maintain treatment access. The ARM is a resource to colleagues and customers, providing leadership and access expertise. The role requires consistently demonstrating ethics and integrity and helping others understand legal and regulatory parameters related to anti-kickback statutes, fraud and abuse, off-label promotion, and OIG guidance concerning patient assistance programs. The successful candidate can prioritize business needs, solve complex problems, build strong customer relationships, motivate others to move cases forward, and adapt quickly to changing business needs in a fast-paced environment. The position involves customer interaction and field travel of up to 60%, with overnight travel dependent on geography. The role is based in Long Island, New York, with additional locations in Brooklyn and Queens.
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.
- Demonstrated analytical, problem-solving, and relationship-building skills.
- Excellent communication, organizational, and leadership skills.
- Bachelor’s degree or higher.
- 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 the pull-through process on open cases through compliant actions that improve access and expedite patients’ starts of treatment.
- Work with prescribing offices, contracted Specialty Pharmacies, the Patient Service Center, and sales colleagues to facilitate treatment access.
- Identify payer trends, alert business partners, and develop, coordinate, and execute tactical access plans.
- Help colleagues and customers understand legal and regulatory parameters related to anti-kickback statutes, fraud and abuse, off-label promotion, and OIG guidance on patient assistance programs.
- Work with a Patient Service Center or Hub to design case-specific strategies based on payer mix, benefit design, and authorization requirements.
- Coordinate case pull-through with the Patient Service Center, Case Managers, Sales, and Specialty Pharmacies.
- Support and educate HCP offices on best practices that streamline authorization and expedite patient access to treatment.
- 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.
Stand Out From the Crowd
Upload your resume and get instant feedback on how well it matches this job.
What This Job Offers
Job Type
Full-time
Career Level
Mid Level
