Field Reimbursement Manager - West

Sobi • Waltham, MA

1d • $115,000 - $150,000 • Remote

About The Position

Reporting to the Director of Field Reimbursement, the Field Reimbursement Manager (FRM) is an important member of the Sobi Market Access team. The FRM is a field-based, non-promotional resource for health systems, institutions, hospitals, and HCP practices/groups that serves as the key to help unlock patient access and resolve reimbursement issues. The FRM is a critical component of customer support and will rely on strong problem-solving skills to provide an outstanding customer experience for patients, providers and staff to ease the burden of access and improve access awareness to Sobi therapies. This is a field-based role with regular travel throughout the assigned territory. Preference is given to candidates residing within the territory, which includes California, Washington, Oregon, Alaska, Hawaii, and portions of Idaho and Nevada.

Requirements

• A minimum of a B.A/B.S. required
• A minimum five (5) years of work experience in Pharmaceuticals/Biotech/Medical Device with relevant understanding of the following areas: Patient journey navigation, Payer coverage polices, Pharmacy benefit reimbursement, Specialty pharmacy and distribution, Hub and Patient Services
• Demonstrated ability to work accounts; specifically working to identify, engage and build relationships with key reimbursement contacts, access personnel and practice managers within identified accounts.
• Industry Knowledge – proficient understanding of the pharmaceutical industry, disease state and drug distribution process (e.g., medical, specialty pharmacy, managed care systems, etc.)
• Understanding of Medicare and Medicaid drug coverage and current and pending changes to drug coverage benefits
• Technical Expertise (Reimbursement and Patient Access) —Demonstrates strong technical expertise
• Reimbursement and patient access knowledge with the ability to effectively convey knowledge to key stakeholders.
• Computer Skills – Ability to effectively use technology to support escalation work internal and external portals and databases
• Advanced Microsoft Excel skills that support analysis of large databases and manage a high volume of data
• Analytical Skills – Ability to analyze and leverage data/reports to identify trends and opportunities
• Demonstrates Passion, high energy, excitement, and a sense of urgency toward organizational purpose and values.
• Cultivates High IMPACT Partnerships with internal and external partners—Develops meaningful partnerships based on Sobi Core Values striving to earn and preserve the trust, respect, and admiration of all stakeholders.
• Values & Unlocks Collaboration—Cultivates an atmosphere of interdependence, collaboration, and reciprocal communication that creates a winning environment that inspires all to demand the ‘best’ from themselves because winning is fun and fulfilling.
• Business Savvy—Demonstrates a clear understanding of the current territory business situation, marketplace, and environment
• Understand HIPAA rules and regulations related to patient privacy
• Strong written and verbal communications as well as presentation skills

Nice To Haves

• Reimbursement experience
• Hematology/Oncology experience
• Candidates residing within the territory, which includes California, Washington, Oregon, Alaska, Hawaii, and portions of Idaho and Nevada.

Responsibilities

• Maintain a targeted account list and proactively engage customers through both virtual and in-person interactions
• Build and maintain strong relationships with key stakeholders including medication access teams, pharmacy, office/practice managers, and reimbursement/procurement departments
• Serve as a reimbursement and access expert across all payer channels (Commercial, Medicare, Medicaid, Government), identifying compliant solutions to access challenges
• Educate customers on benefit verification, prior authorizations, appeals, specialty pharmacy/distribution models, CPT coding, and J-codes
• Act as a bridge between customers, patient services (HUB), sales, and account teams to resolve access barriers and escalations
• Collaborate with Doptelet and Vonjo Connect HUBs and case managers to compliantly address escalations and access issues for hub patients
• Provide feedback and insights to internal stakeholders to inform strategy and improve patient access solutions
• Partner closely with local cross-functional colleagues to support accounts within a defined geography
• Demonstrates deep knowledge in reimbursement and access across all channels (Commercial, Medicare, Medicaid, Exchange and Government) and is the subject matter expert of the payers in the markets they will support
• Demonstrates deep knowledge in all phases of specialty distribution, specialty pharmacy core services to assist with supporting access and product procurement healthcare structures, payment systems, and reimbursement methodology
• Works collaboratively with internal and external business partners to win—Thinks and acts as a team; understands the nature and interdependencies of a matrix team environment and can effectively work cross-functionally to seize opportunities, resolve payer issues, improve customer experience, avoid bureaucracy, and maximize outcomes of strategies and key actions.
• Educates health systems, institutions, hospitals, and HCP office staff about Patient Service Program options to optimize patient access to Sobi’s products, Prior authorization requirements, coverage status, and payer appeals requirements, processes, and timelines
• Comprehends and effectively demonstrates ability to conduct field-based customer support related to payer coverage and payment process (coverage navigation & specialty pharmacy fulfilment)
• Adheres to all relevant regulatory and Sobi compliance & ethics guidelines and a willingness to coach to ensure a culture of compliance

Benefits

• Competitive compensation for your work
• Generous time off policy
• Summer Fridays
• Opportunity to broaden your horizons by attending popular conferences
• Emphasis on work/life balance
• Collaborative and team-oriented environment
• A competitive 401(k) match to support your financial future.
• Tuition and wellness reimbursements to invest in your personal and professional growth.
• A comprehensive medical, dental, and vision package to prioritize your health and well-being.
• Additional recognition awards to celebrate your achievements.
• this role is eligible for both short-term and long-term bonuses

What This Job Offers

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