Access & Reimbursement Manager Immunology - Indianapolis, IN
About The Position
The Access & Reimbursement Manager (ARM) is a remote and field-based role responsible for serving as the key contact and lead for access and reimbursement support-related matters. The ARM acts as the local market access expert on payer policy coverage, multi-channel acquisition pathways, billing and coding, claims processing, reimbursement, and the integration of manufacturer support programs into account workflows. This role requires strong problem-solving skills, the ability to analyze access and reimbursement issues and opportunities, and proactive communication regarding changes in the healthcare landscape. The ARM will collaborate closely with other Novartis Pharmaceuticals Corporation (NPC) field associates, including Customer Engagement (Sales) and Market Access, representing NPC with integrity. Cross-functional coordination within NPC (e.g., Patient Support Center, Customer Engagement, Marketing, Market Access, Public Affairs, State & Government Affairs, Trade, Specialty Pharmacy Account Management) is also a key aspect of this position.
Requirements
- Minimum three to five years’ experience in public or private third-party Reimbursement arena or pharmaceutical industry in managed care, clinical support, or sales.
- Experience with specialty pharmacy products acquired through Specialty Pharmacy networks or specialty distributors (buy and bill).
- Experience with coding, billing, and office support programs.
- Prior account management experience or prior experience with complex accounts (Payer landscape, high patient volume, large systems).
- Knowledge of Managed Care, Government, and Federal payer sectors, as well as Integrated Delivery Network/Integrated Health Systems.
- Ability to operate as a “team player” in collaborating with multiple sales representatives, sales leadership, and internal colleagues to reach common goals.
- Candidate must reside within territory, or within a reasonable daily commuting distance of 60 miles from the territory border.
- Ability to travel 60-80% over a broad geography is required.
- Ability to drive and/or fly within the territory.
- Must have a valid driver’s license.
Nice To Haves
- Experience working within Buy and Bill environments, including reimbursement and access support for provider-administered therapies.
Responsibilities
- Interact within assigned accounts to support patient access within their therapeutic area product(s).
- Provide proactive face-to-face education on product-specific programs to providers and staff to support integration into office processes and workflows.
- Analyze problems and offer solutions.
- Understand and support questions associated with payer policies (e.g., utilization management, denial, and appeals), drug acquisition and inventory management, and patient/practice reimbursement (e.g., Co-pay, administration, drug claims).
- Analyze account reimbursement issues & opportunities.
- Identify trends at a local, regional, and national level and partner internally and externally to support patient pull-through.
- Interface with the Patient Support Center (hub) on matters related to patient case management, including tracking cases, issue resolution, reimbursement support, and office staff education.
- Review patient-specific information when assistance is requested and patient health information is available to resolve issues or coverage challenges.
- Collaborate with aligned cross-functional associates within NPC to share insights on customer needs and barriers related to access and reimbursement for their aligned therapeutic area product(s).
- Maintain a deep understanding of NPC policies and requirements and perform all responsibilities with integrity and in accordance with company guidance and prescribed Values and Behaviors.
- Handle Patient Identifiable Information (PII) appropriately, ensuring compliance with HIPAA and other privacy laws, regulations, and internal Company compliance guidelines.
Benefits
- Health, life and disability benefits
- 401(k) with company contribution and match
- Generous time off package including vacation, personal days, holidays and other leaves
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
