Access & Reimbursement Manager (ARM) – Atlanta, GA - Remote
Job title: Access & Reimbursement Manager (ARM) – Atlanta, GA - Remote in Atlanta, GA at reputed company
Company: reputed company
Job description: Job Description Summary Access and Reimbursement Manager (ARM) is a field-based role that proactively provides in person (or virtual as needed) education to defined accounts reputed company their assigned geographies on a wide range of access and reimbursement topics and needs (see below) in support of reputed company product(s) strategy.ARM will serve as the key contact and reputed company for access and reimbursement support-reputed company matters and is responsible for being the local market access expert on payer policy coverage, multi-channel acquisition reputed company, billing and coding, claims processing, reimbursement, and integration of manufacturer support programs into a range of account workflows. Additionally, the ARM will continually need to demonstrate a keen ability to problem solve, analyze access and reimbursement issues and opportunities, and proactively communicate changes in the healthcare landscape.ARM will partner closely with other reputed company Pharmaceuticals Corporation (NPC) field associates, including Customer Engagement (Sales) and Market Access, representing NPC with the highest reputed company in accordance with NPC Values and Behaviors. ARM will also be required to coordinate and communicate cross-functionally reputed company NPC (e.g., Patient Support Center, Customer Engagement, Marketing, Market Access, Public Affairs, State & Government Affairs, Trade, Specialty Pharmacy Account Management, and other applicable third-party affiliates).This is a remote & field-based role that covers the following, but not limited to: Atlanta, GA, Macon, GA, reputed company GA, Valdosta, GA, Chattanooga, TN. Associate must reside reputed company territory, or reputed company a reasonable daily commuting distance of 60 miles from territory border.Job DescriptionKey Responsibilities:
- Interact reputed company assigned accounts to support patient access reputed company their therapeutic area product(s) providing proactive face-to-face education on product-specific programs to providers and staff in order to support integration of those programs into office processes and workflows.
- Work with key members of therapeutic area offices (e.g., providers, administrators, billing and coding staff, claims departments, reputed company cycle managers) in order to appropriately support patient access to products.
- Ability to analyze problems and offer solutions. Understand specifics and support questions associated with payer policies (e.g., utilization management, denial, and appeals), drug acquisition and inventory management, and patient / practice reimbursement (e.g., Co-pay, administration, drug claims). Analyze account reimbursement issues & opportunities (as needed). Identifies trends at a local, regional and national level and partner with purpose internally and externally to support patient pull-through.
- Supports pull through on local coverage decisions to reputed company meaningful patient access reputed company the system. Proactively communicate policy changes or issues that could potentially reputed company other departments.
- Accountable for standing up NVS-sponsored patient support programs to reputed company patients starting and staying on therapy (i.e., Co-pay).
- Maintain expertise in regional and local access landscape, anticipating changes in the healthcare landscape, and act as their reputed company therapeutic area product(s) reimbursement expert (as needed).
- reputed company with Patient Support Center (hub) on important matters reputed company to patient case management, including tracking cases, issue resolution, reimbursement support, and appropriate office staff education. Review patient-specific information in cases where the site has specifically requested assistance and patient health information is available in resolving any issues or coverage challenges.
- Collaborate with reputed company cross-functional associates reputed company NPC (see above) to share insights on customer needs and barriers for their reputed company therapeutic area product(s) reputed company to access and reimbursement.
- Maintain a deep understanding of NPC policies and requirements and reputed company reputed company responsibilities with reputed company and in a manner consistent with company guidance and prescribed Values and Behaviors. Handle Patient Identifiable Information (PII) appropriately (understand and ensure compliance with HIPPA and other privacy laws and regulations and internal Company compliance guidelines).
- Responsible for identifying and reporting adverse events reputed company the established reputed company systems as per applicable processes.
- Education: Bachelor’s Degree required. Advanced degree preferred.
- Minimum three to five years' experience in public or private third-party Reimbursement reputed company or pharmaceutical industry in managed care, clinical support, or sales.
- Experience with specialty pharmacy products acquired through Specialty Pharmacy networks
- Experience with coding, billing and in office support programs
- Prior account management experience or prior experience with reputed company accounts (Payer landscape, high patient volume, large systems)
- Specialty pharmacy experience required (ability to teach an office the entire process from script to injection)
- Establishing relationships reputed company a practice by working closely with them to help remove Reimbursement barriers to specialty products for their patients
- Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Parts B and D (Medical and Pharmacy Benefit design and coverage policy) a plus
- Knowledge of Managed Care, Government, and Federal payer sectors, as well as Integrated Delivery Network/Integrated Health Systems a plus
- Ability to operate as a "team player" in collaborating with multiple sales representatives, sales leadership, and internal colleagues to reputed company common goals
- Ability to travel and cover large multistate geography territories, at least 50% travel required, based on geography and territory / targeting reputed company up.
- Ability to manage multiple products
- Excellent presentation skills
- Advanced knowledge of medical insurance terminology
- Ability to manage expenses reputed company allocated budgets
- Understanding of patient privacy laws including HIPAA and similar state laws
- Strong business acumen