Access & Reimbursement Manager, Cardiovascular - Central IL & St Louis MO Territ
Scorpion Therapeutics, Bloomington, Illinois, us, 61791
Want to use specialized AI just for BioPharma to compete for this highly desirable role? Check out our updated tool https://jobsai.medicinetomarket.com today!
Role Summary Remote/field-based Access and Reimbursement Manager (ARM) who educates defined accounts on access and reimbursement topics to support product strategy. The ARM serves as the local market access expert on payer policy coverage, billing and coding, claims processing, reimbursement, and integration of manufacturer support programs into account workflows, and communicates changes in the healthcare landscape. The role partners with NPC field teams and cross-functional colleagues to address customer needs and ensure patient access within the St. Louis, MO territory (including Springfield, IL; Peoria, IL; Champagne, IL; Bloomington, IL), with a commuting radius up to 60 miles.
Responsibilities
Interact within assigned accounts to support patient access within their therapeutic area product(s) by providing proactive, face-to-face education on product-specific programs to providers and staff and integrating those programs into office processes and workflows.
Address customer questions for issues related to NPC policies on product ordering, payment, inventorying, and product returns & replacement in offices.
Work with key members of therapeutic area offices (providers, administrators, billing and coding staff, claims departments, revenue cycle managers) to support patient access to products.
Analyze problems and offer solutions; understand payer policies (utilization management, denial, and appeals), drug acquisition and inventory management, and patient/practice reimbursement (Co-pay, administration, drug claims); identify trends and partner to support patient pull-through.
Support pull-through on local coverage decisions to enable meaningful patient access and proactively communicate policy changes or issues.
Stand up NPC-sponsored patient support programs to enable patients starting and staying on therapy (e.g., Co-pay).
Maintain expertise in regional/local access landscape and act as the reimbursement expert for aligned products as needed.
Interface with the Patient Support Center on patient case management, including tracking cases, issue resolution, reimbursement support, and education of office staff; review patient-specific information as requested.
Collaborate with cross-functional NPC associates to share insights on customer needs and barriers related to access and reimbursement for aligned products.
Maintain understanding of NPC policies and ensure compliance with privacy laws and internal guidelines while handling patient identifiable information appropriately.
Identify and report adverse events via established company systems as applicable.
Qualifications
Required: Bachelor’s Degree.
Preferred: Advanced degree.
Required: Minimum three to five years’ experience in public or private third-party reimbursement or pharmaceutical industry in managed care, clinical support, or sales.
Required: Experience with specialty pharmacy products acquired through Specialty Pharmacy networks or specialty distributors (buy and bill).
Required: Experience with coding, billing and in-office support programs.
Required: Prior account management experience or prior experience with complex accounts (payer landscape, high patient volume, large systems).
Required: Specialty pharmacy experience (ability to teach an office the entire process from script to injection).
Required: Establishing relationships within a practice by working closely with them to remove reimbursement barriers to specialty products for their patients.
Preferred: Knowledge of CMS policies and processes with expertise in Medicare Parts B and D (Medical and Pharmacy Benefit design and coverage policy).
Preferred: Knowledge of Managed Care, Government, and Federal payer sectors, as well as Integrated Delivery Network/Integrated Health Systems.
Education
Bachelor’s Degree required. Advanced degree preferred.
Additional Requirements
Travel: Ability to travel and cover large multistate geography territories; at least 50% travel required.
Location: Must reside within assigned territory or within a reasonable daily commuting distance (up to 60 miles) from the territory border.
Driving: Driving is an essential function of this role; must have a fully valid and unrestricted driver’s license.
Accommodations: The company provides reasonable accommodations for otherwise qualified individuals with medical restrictions if an accommodation can be provided without eliminating the essential function of driving.
#J-18808-Ljbffr
Role Summary Remote/field-based Access and Reimbursement Manager (ARM) who educates defined accounts on access and reimbursement topics to support product strategy. The ARM serves as the local market access expert on payer policy coverage, billing and coding, claims processing, reimbursement, and integration of manufacturer support programs into account workflows, and communicates changes in the healthcare landscape. The role partners with NPC field teams and cross-functional colleagues to address customer needs and ensure patient access within the St. Louis, MO territory (including Springfield, IL; Peoria, IL; Champagne, IL; Bloomington, IL), with a commuting radius up to 60 miles.
Responsibilities
Interact within assigned accounts to support patient access within their therapeutic area product(s) by providing proactive, face-to-face education on product-specific programs to providers and staff and integrating those programs into office processes and workflows.
Address customer questions for issues related to NPC policies on product ordering, payment, inventorying, and product returns & replacement in offices.
Work with key members of therapeutic area offices (providers, administrators, billing and coding staff, claims departments, revenue cycle managers) to support patient access to products.
Analyze problems and offer solutions; understand payer policies (utilization management, denial, and appeals), drug acquisition and inventory management, and patient/practice reimbursement (Co-pay, administration, drug claims); identify trends and partner to support patient pull-through.
Support pull-through on local coverage decisions to enable meaningful patient access and proactively communicate policy changes or issues.
Stand up NPC-sponsored patient support programs to enable patients starting and staying on therapy (e.g., Co-pay).
Maintain expertise in regional/local access landscape and act as the reimbursement expert for aligned products as needed.
Interface with the Patient Support Center on patient case management, including tracking cases, issue resolution, reimbursement support, and education of office staff; review patient-specific information as requested.
Collaborate with cross-functional NPC associates to share insights on customer needs and barriers related to access and reimbursement for aligned products.
Maintain understanding of NPC policies and ensure compliance with privacy laws and internal guidelines while handling patient identifiable information appropriately.
Identify and report adverse events via established company systems as applicable.
Qualifications
Required: Bachelor’s Degree.
Preferred: Advanced degree.
Required: Minimum three to five years’ experience in public or private third-party reimbursement or pharmaceutical industry in managed care, clinical support, or sales.
Required: Experience with specialty pharmacy products acquired through Specialty Pharmacy networks or specialty distributors (buy and bill).
Required: Experience with coding, billing and in-office support programs.
Required: Prior account management experience or prior experience with complex accounts (payer landscape, high patient volume, large systems).
Required: Specialty pharmacy experience (ability to teach an office the entire process from script to injection).
Required: Establishing relationships within a practice by working closely with them to remove reimbursement barriers to specialty products for their patients.
Preferred: Knowledge of CMS policies and processes with expertise in Medicare Parts B and D (Medical and Pharmacy Benefit design and coverage policy).
Preferred: Knowledge of Managed Care, Government, and Federal payer sectors, as well as Integrated Delivery Network/Integrated Health Systems.
Education
Bachelor’s Degree required. Advanced degree preferred.
Additional Requirements
Travel: Ability to travel and cover large multistate geography territories; at least 50% travel required.
Location: Must reside within assigned territory or within a reasonable daily commuting distance (up to 60 miles) from the territory border.
Driving: Driving is an essential function of this role; must have a fully valid and unrestricted driver’s license.
Accommodations: The company provides reasonable accommodations for otherwise qualified individuals with medical restrictions if an accommodation can be provided without eliminating the essential function of driving.
#J-18808-Ljbffr