ViiV Healthcare (GSK) Associate Director, Field Reimbursement - Sacramento, CA

GSK•Rocklin, CA

1d•Remote

About The Position

The Associate Director, Field Reimbursement addresses a critical gap in the US healthcare system – the complexity of post-prescribing access barriers. In therapeutic areas such as HIV/AIDS, where PrEP and treatment access could involve multiple acquisition pathways, evolving payer policies, and intricate benefit determination processes, significant complexity can delay or disrupt patient access to prescribed therapies. The Associate Director, Field Reimbursement will simplify and accelerate: VHC Injectable implementation and user experience for Healthcare Providers, patients living with HIV, and people who can benefit from HIV Prevention within a specified geographic region. Field Reimbursement personnel serve as field-based customer facing educational resources, equipping healthcare providers and office staff with the knowledge and tools to independently navigate these reimbursement complexities. By providing education to Customers this function helps prevent access disruptions before they occur to help ensure patients can access their prescribed medicine. When complex reimbursement issues do arise post-prescription, Field Reimbursement personnel provide specialized guidance to support resolution. The ADFR will operate as the subject-matter expert on reimbursement, access, and coverage issues affecting ViiV’s long acting injectables to facilitate appropriate patient access.

Requirements

Bachelor’s Degree
5 or more years of experience in pharmaceutical or healthcare reimbursement, specialty product support, payer marketing, patient support programs, or reimbursement HUB programs.
Experience with J codes, Q codes, and reimbursement billing requirements.
Ability to travel 50% plus of the time

Nice To Haves

Strong knowledge of payer channels including Medicare Parts B, C, D, Medicaid, and commercial insurance.
Experience with specialty injected or infused products in buy-and-bill settings across sites of care.
Experience working with specialty pharmacy and reimbursement HUB services.
Exceptional Communication skills with demonstrated ability to simplify complex systems and persuade
Strong relationship management, problem-solving, and independent execution skills.
Demonstrated ability to effectively educate offices on access and reimbursement processes.
Proactive implementation execution excellence focused on streamlining and simplifying processes.
Proven indirect/direct leadership with demonstrated peer collaboration effectiveness.
Knowledge of aligned accounts and existing customer relationships.

Responsibilities

Mitigate access and reimbursement disruptions through education of office staff on payer coverage and policies, and acquisition pathways.
Educate offices in navigating access and reimbursement challenges independently through the post-prescribing phase.
Support complex access and reimbursement issues as needed.
Identify and prioritize implementation barriers for removal at customer campuses.
Develop strategic plans that include next actions, action owners and completion dates.
Drive implementation barrier closure.
Orchestrate coordinated plans across internal partners for aligned customers, built from a shared diagnosis.