Access and Reimbursement Manager (NYC Metro)

Mallinckrodt Pharmaceuticals•Long Island, NY

About The Position

The Access and Reimbursement Manager (ARM) helps create and maintain treatment access for patients throughout their course of therapy. While sales specialists drive new business demand, the ARM leads the pull-through process for open cases by taking compliant actions that improve access and expedite treatment starts. The ARM 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 patient access. As a leader and access expert, the ARM 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, including anti-kickback statutes, fraud and abuse, off-label promotion, and OIG guidance related to patient assistance programs. The ideal candidate thrives in a fast-paced environment, prioritizes business needs, solves complex problems, builds strong customer relationships, motivates others to move cases forward, and adapts quickly to changing business needs. The role includes customer interaction and field travel up to 60%; overnight travel depends on geography.

Requirements

At least 5 years of experience working with specialty pharmaceutical products, or at least 2 years of access-related experience outside the pharmaceutical industry.
Strong understanding of insurance and benefit design with commercial and government payers.
Experience in Access & Reimbursement, payer account management, Specialty Pharmacy distribution, Patient Services, or Case Management.
Successful navigation of 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 required.
Ability to travel in the field up to 60%; overnight travel depends on geography.

Nice To Haves

Experience in ophthalmology, nephrology, rheumatology, pulmonology, neurology, or dermatology.

Responsibilities

Lead compliant pull-through activities on open cases to improve treatment access and expedite patient starts.
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, including anti-kickback statutes, fraud and abuse, off-label promotion, and OIG guidance related to 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.
Communicate with Specialty Pharmacies to improve processing time and facilitate shipment scheduling.
Identify and prioritize business needs, solve complex problems, build customer relationships, and motivate others to move cases forward.
Travel in the field and interact with customers, with travel up to 60% and overnight stays depending on geography.