Associate Director, Reimbursement and Access - Southwest

Pharming Group N.V.

1d•$170,000 - $190,000•Hybrid

About The Position

Reporting to the Senior Director – Patient Access & Support Service, the Associate Director, Reimbursement and Access (RAD) will support patient and healthcare providers (HCPs) across sites of care in gaining access for patients to Ruconest. The goal is to ensure that HCPs have the most up to date information when prescribing and working through the approval and logistics processes for Ruconest. Successful execution will involve the RAD being a regional expert in patient access, reimbursement, prior authorization appeal, obtaining financial assistance, and navigation through any complex access related issues. RADs are regionally split across the U.S., supporting Pharming sales team territories in their assigned regions. This position would be responsible for the Southwest region primarily serving Texas, Arizona, Nevada, Oklahoma and Louisiana. This is an individual contributor role.

Requirements

Bachelor’s Degree from an accredited university.
3+ years’ experience as a Field Reimbursement Manager.
5+ years cross-functional experience in the pharmaceutical/biotech industry.
2+ Years' experience with prior authorization and multi-level appeals.

Nice To Haves

3+ years’ experience as a Field Reimbursement Manager for a biologic / buy & bill (physician-administered, IM/SC injectable, IV injection, infusion) drug experience highly preferred.
Immunology background and rare or ultra-rare disease industry experience highly preferred.
Excellent working knowledge of reimbursement and access challenges in the current healthcare environment.
Ability to communicate payer coverage criteria and prior authorization/appeals processes to HCPs and staff including prepping HCP’s for Peer-to-Peer discussions.
Experience working with Specialty Pharmacies to resolve access issues.
Experience working with a Hub to obtain necessary payer information and facilitating next steps.
Experience working with multiple internal stakeholders. (sales, managed markets, patient advocacy, government affairs, etc.)
Demonstrated ability to apply reimbursement knowledge to address/resolve patient access barriers.
Possess interpersonal skills including managing and resolving conflict and building strong working relationships.
Proven track record for consistently meeting or exceeding goals and objectives.
Proficient in working in a cross functional environment while handling multiple tasks.
Travel - Include 50% travel time required for the position where travel occurs locally or internationally. Travel to HCP offices, with or without Sales Reps, to work with appropriate level stakeholders to respond to coverage or payment issues (i.e., 2 to 3 days in the field).
Commitment and alignment to Pharming’s mission, core values and behaviors.

Responsibilities

Handling all coverage, reimbursement and access needs across their territories/regions and work directly with their respective Sales Representatives, Hub Case Managers, National Account Directors (NADs) and customers (HCP facing).
Work directly with Hub vendor to understand payer coverage issues and assist with prior-authorization (PA) denials and appeals by working with physicians and staff, helping prepare HCPs for Peer-to-Peer needs.
Proactively track patients from submission of enrollment form through to shipment in order to identify potential issues and work to enable timely resolutions.
Provide training and education to HCPs on payor specific coverage policies and authorization documentation requirements, appeals processes and patient financial assistance support programs.
Develop and maintain positive working relationships with both internal team members (e.g., Sales Reps, NADs, Case Managers and Clinical Educators) and external stakeholders (e.g., physicians, office staff, Specialty Pharmacy partners).
Work with HCPs and specialty pharmacy to overcome quantity limits or high dollar overrides.
Escalate and engage the NAD when payer coverage or payment issues are identified, providing detailed specifics on issues, steps attempted to resolve, and identify key items that need addressing with the payer.
Communicate issues and status with internal stakeholders and leaders (NADs, RBDs, VP of Sales).
Communicate opportunities and challenges related to patient access issues to internal stakeholders.
Work collaboratively to improve access and reimbursement tools and processes.
Performs other duties as assigned.

Benefits

Flexible hybrid work schedule to promote a healthy work-life balance
Competitive compensation package including annual target bonus
Long-term incentive program
401(k) plan with company match
Paid Time Off (PTO)
13 Company Holidays per year
Excellent benefit plans including medical, dental, and vision
Flexible spending accounts
Company-provided life insurance, short-term disability, and long-term disability plans
Optional accident, hospital indemnity, critical illness, and pet insurance plans
Tuition reimbursement program
Health and wellness program
Choice of company provided mobile phone or cell phone stipend