Rare Reimbursement Executive, Southwest

UCB • Phoenix, AZ

3h • Hybrid

About The Position

This is a field-based position that requires up to 75% daily and overnight travel and will cover Arizona & Nevada, supporting the Pacific and Mountain Time Zones. The role is designed to ensure that appropriate patients have access to UCB rare disease products and Patient Services. The Executive will provide ethical commentary on local, regional, and national payer coverage and their pharmacy and medical policies to all engaged sites of care. This role requires leveraging knowledge in the market access and reimbursement journey, encompassing procurement, payer policies and coverage, benefit design, prior authorizations, appeals, exceptions, denials, coding and payer payment guidelines, site of care regulation/requirements, and understanding of coding guidelines within the complex payer environment. The Executive will relay detailed benefit information to maximize the Provider and Staff experience, including market dynamics, coverage, billing, coding, and reimbursement policies for all sites of care involved.

Requirements

• Bachelor’s degree required
• 8+ years of pharmaceutical or biotech experience required
• Demonstrated working knowledge of medical and pharmacy benefit reimbursement including benefit investigation required

Nice To Haves

• Master’s preferred
• 4+ years Reimbursement/Account Management experience preferred
• Excellent working knowledge of evolving reimbursement landscape and the practice management environment
• Neurology or Rare Disease experience preferred

Responsibilities

• Serve as a liaison to all engaged sites of care administering UCB rare disease product(s) through a patient’s medical benefit and pharmacy benefit.
• Provide support to patients and accounts specific to benefit verifications, product procurement processes, reimbursement information, billing, coding, and coverage details.
• Provide on-demand education, including Lunch and Learns or Dinner presentations, for office staff regarding Reimbursement and support services.
• Advise all sites of care on payer specific nuances related to utilization management protocols, appeals processes and the year-end re-authorization verification process.
• Work with all engaged sites of care to inform them on matters related to access and reimbursement of UCB rare disease products.
• Act as the sole point of contact for all stakeholders should a Medical Claim denial be presented by a provider.
• Develop strategic coverage, access and reimbursement relationships with their local Medicare Part A/B Contractors and attend Medicare Part A/B Contractor open meetings.
• Provide coverage updates, policy changes and communications to internal UCB colleagues.
• Provide strategic coverage and reimbursement, benefit recertification support and marketplace feedback to internal colleagues aligned to their geographies.
• Monitor, interpret, and communicate local, regional, and national payer policy updates impacting UCB Rare Disease therapies.
• Provide reimbursement education and ethical commentary regarding medical and pharmacy benefit coverage, benefit design, utilization management requirements, coding practices, reimbursement methodologies, and payer policy changes.
• Disseminate relevant coverage and policy updates to internal stakeholders and aligned cross-functional teams.

Benefits

• We have a caring, supportive culture where everyone feels included, respected, and has equal opportunities to do their best work.
• At UCB, we don’t just complete tasks, we create value.
• We aren’t afraid to push forward, collaborate, and innovate to make our mark for patients.
• Working for us, you will discover a place where you can grow, and have the freedom to carve your own career path to achieve your full potential.

What This Job Offers

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