Access and Reimbursement Manager (N Illinois/Wisconsin/Minneapolis)

Mallinckrodt Pharmaceuticals • Minneapolis, MN

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About The Position

The Access and Reimbursement Manager (ARM) helps create and maintain patient access to treatment throughout the course of therapy. While sales specialists drive new business demand, the ARM leads the pull-through process on open cases by taking compliant actions that improve access and expedite treatment starts. 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 role also provides access expertise to colleagues and customers and helps them understand legal and regulatory parameters, including anti-kickback statutes, fraud and abuse, off-label promotion, and OIG guidance related to patient assistance programs. The position requires adapting to changing business needs, prioritizing effectively, solving complex problems, building customer relationships, and motivating others to move cases forward.

Requirements

• At least 5 years of experience working with specialty pharmaceutical products, or at least 2 years of experience in an access-related position outside the pharmaceutical industry.
• 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.
• Ability to travel in the field and interact with customers up to 60%; overnight travel depends on geography.
• Bachelor’s degree or higher.

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 using compliant actions to 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 and customers understand legal and regulatory parameters related to anti-kickback statutes, fraud and abuse, off-label promotion, and OIG guidance concerning 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 healthcare provider offices on practices that streamline authorization and expedite patient access to treatment.
• Communicate with Specialty Pharmacies to improve processing time and help facilitate shipment scheduling.

Benefits

• Competitive pay and benefits as part of a Total Rewards package.
• Eligibility for a bonus in accordance with the applicable program; bonuses are awarded at the Company’s discretion.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level