- The Access and Reimbursement Manager (ARM) is responsible for executing the market access business plan pertaining to the assigned geography, working with provider offices to ensure both providers and their staff are educated on payer and reimbursement policies and procedures, as well as providing expertise on the REMS program and patient support services.
- The ARM will work in collaboration with Field Sales, Sales Management, Patient Support Services, Managed Markets, Trade & Distribution, internal commercial teams, and other cross-functional partners to achieve the business unit objectives.
- The ARM will also develop relationships with all key personnel, targeted physicians, office managers, and staff vital to making company's products accessible within key customer accounts.
- Provider and account interface, as well as billing and coding education within compliance, will be a key focus.
- This position will also play a critical role in ensuring REMS provider and patient enrollment, education on REMS process and requirements, and serve as an expert on patient support services.
- Establish and maintain strategic relationships with assigned providers and provider accounts.
- Educate and enhance awareness and utilization of patient access services, ensure providers understand payer prior authorization requirements and information, and educate offices on coding and billing
- Serve as a field-based expert on the REMS program processes and procedures, including enrollment requirements for providers and patients.
- Educate and inform provider offices on available patient services, collaborating and communicating with the Patient Access group and the Specialty Pharmacy to ensure optimal customer experience.
- Collaborate and coordinate with area and regional sales teams to develop payer and reimbursement action plans for key provider accounts.
- Monitor, document, and communicate coverage policy and changes.
- Collaborate with internal and external partners to maintain a payer coverage and reimbursement database, and communicate changes to field sales and sales management teams.
- Collaborates with Managed Markets to pull-through business opportunities with Commercial Payers, state Medicaid Agencies, Managed Medicaid Organizations, Healthcare Maintenance Organizations, Pharmacy Benefit Organizations, Health Care Plans, GPOs, DOD and Veterans Integrated Service Networks and other strategic healthcare entities specific to assigned initiatives and product requirements.
- Conducts annual business development reviews for company corporate and division management, as well as required updates and reviews with assigned area and regional sales team(s).
- Provide managed care and reimbursement training and educational activities for internal and external stakeholders.
- Remain current on key managed care, reimbursement, and policy activities, as well as serve as an expert for our company on business trends within key provider accounts.
- Ensure all pertinent information regarding current products, new products, competitive data and overall information important to our company is brought to the attention of proper company personnel.
- Represent our company at various industry functions such as payer and reimbursement meetings, payer policy meetings, professional organization meetings, and other meetings as assigned.
- Demonstrates territory planning, priorities, and time management specific to geographical area of responsibility.
- Maintains accurate expenses within budget, timely and accurate completion of all reports, correspondence, and records as required by our company.
- Execution of all activities within the defined company regulatory and compliance program.
- Maintain company manuals, reports, computer systems, records, brochures, computers and other equipment assigned to the position.
- BA/BS Degree (MBA preferred), and at least 5 years of pharma, biopharmaceutical, and/or medical device experience calling on field based customers with demonstrated successful track record.
- Account Management and/or Reimbursement experience working in the provider office setting, building strong customer relationships.
- Experience working with HUB, Patient Services, and/or REMS programs.
- Experience in building a team atmosphere with sales representatives, either with direct or indirect leadership authority.
- Ability to make sound decisions within time/resource constraints.
- Proven skills in strategic decision-making and problem-solving.
- Excellent analytical skills focusing on key accounts and uncovering business opportunities.
- Experience working with billing and medical claims personnel in healthcare settings preferred.
- Proficient with MS Office including Excel, Word, PowerPoint preferred
- Candidates should live near a major airport and be willing and able to travel approximately 70-75% of the time (average 3-4 days per week).
REQUIRED EDUCATION / CERTIFICATIONS / LICENSES
- BA/BS Degree (MBA preferred)
- CPC, or similar coding certification preferred, not required
- Extensive travel required
DESCRIPTION OF PHYSICAL DEMANDS
- Frequent travel between meeting sites.
- Frequently operating a computer, printer, telephone and other similar office machinery.
DESCRIPTION OF WORK ENVIRONMENT
- Frequent interactions with external contacts in their office environment with little exposure to excessive noise, dust, fumes, vibrations and temperature changes.
- Frequent computer laptop or tablet use, not usually at a workstation.
- Responsibilities may require a work schedule that may include working outside of “normal” work hours, in order to meet business demands.
- Frequent public contact requiring appropriate business apparel.