PSP Operations Manager - Reimbursement

Novartis•Toronto, ON

3d•CA$125,120 - CA$173,700•Hybrid

About The Position

Novartis is seeking experienced and passionate professionals to join us in accomplishing our ambitious mission of reaching twice as many patients twice as fast. As PSP Operations Manager, Reimbursement, you will have ownership of our Retrobilling and Copay strategies and play a critical role in identifying and addressing reimbursement process bottlenecks. This role aims to maximize commercialization, improve Time-to-Commercialization and Retrobilling rate, as well as minimize copayment overexposure and misbilling. To succeed, you'll need extensive knowledge of Canadian drug reimbursement, pharmacy Retrobilling, copay card management, payer collaboration, and the ability to extract insights from PSP data. The role reports directly into the PSP Operations Lead and will work closely with PSP Operations, Value and Access, Commercial, Data, product cross-functional teams, and external vendors. This is a permanent position.

Requirements

Hands-on experience with Patient Support Programs (PSPs), collaborating directly with payers to drive reimbursement initiatives, and expertise in national pharmacy retrobilling processes, including the ability to analyze and optimize retrobilling opportunities using data and insights.
Proven experience in managing copay card programs, developing and implementing effective strategies that maximize patient value while minimizing overexposure or misbillings from pharmacies.
Strong interpersonal skills and the ability to work cross-functionally, collaborating with internal teams and external stakeholders to incorporate technology and drive program success.

Nice To Haves

Experience working within a healthcare system as a healthcare professional (HCP) or in a related capacity.
Proficiency in both English and French languages is desirable.

Responsibilities

Analyze data from CRM systems to gain insights into payer behaviors, trends, preferences, and coverage decisions to help identify bottlenecks and areas for improvement in reimbursement.
Collaborate closely with Market Access teams to develop strategies for improving payer bottlenecks and listing criteria.
Alleviate payer bottlenecks by proposing and implementing data-driven solutions, such as reimbursement tools, guidelines, and CRM enhancements.
Continuously monitor and evaluate payer trends, policies, and regulations using CRM data and external resources to help identify shifts in reimbursement policies, market dynamics, and payer preferences.
Strategically develop copayment card programs with appropriate structure, reporting, and management that maximizes patient value while minimizing overexposure and misbillings from pharmacies.
Maximize pharmacy retrobilling nationally by developing and implementing a comprehensive control and oversight process which establishes and monitors targets, proactively identifies missed opportunities, analyzes the root causes of retrobilling errors, and develops strategies to optimize recovery.
Develop comprehensive reporting, proactively identify discrepancies, and implement optimization strategies for PSP and pharmacy performance in commercialization, retrobilling recovery, and copayment expenditures, leveraging influence without formal authority.
Conduct training sessions to enhance cross-functional teams' understanding of reimbursement processes and collaboration with field teams.