Field Reimbursement Manager-San Fernando Valley, CA-Market Access
SUN PHARMA, San Fernando, CA, United States
Overview
The Field Reimbursement Manager is part of the Market Access group supporting Sun’s family of branded products in the United States. The primary goal of this role is to support appropriate patient access to care by assisting practices, accounts, and providers with reimbursement, specialty pharmacy and distribution processes, provider support services, and patient support resources.
The role monitors national and local healthcare payer policies, develops relationships with key advocacy leaders and state societies, and provides direct support to prescribing physicians, hospitals and support staff regarding reimbursement and product access within payer channels.
Responsibilities
Incorporate knowledge of dynamic marketplace and business trends to deliver maximum access to the portfolio of Sun products.
Deeply understand medical vs pharmacy benefit and policy.
Understand the dynamics of specialty pharmacy and specialty distribution.
Demonstrate a broad understanding of the physician buy‑and‑bill model and assignment of benefits to alternate sites of care.
Identify and establish alternate sites of care that support patient options.
Possess expertise in Medicare policies and variations across Medicare parts.
Ensure clear communication processes with sales teams to address reimbursement and access issues and support pull‑through efforts.
Listen and respond appropriately to customer needs and questions.
Effectively communicate with customers using selling, listening, negotiation skills, proper terminology and approved messaging.
Maintain thorough knowledge of Sun products.
Communicate regularly and timely with manager and support teams as required.
Create a positive impression with customers.
Prepare reports for management as needed.
Participate in teleconference and live national, regional, and district meetings, training sessions, and represent Sun at conventions when requested.
Ensure behaviors consistent with Healthcare Compliance guidelines.
Qualifications
A minimum of a Bachelor’s Degree is required.
Five or more years of healthcare industry experience, including at least three years in areas such as insurance verification, claim adjudication, physician office and outpatient billing, medical benefit procurement, and payer adjudication within commercial and government payers.
Experience with buy‑and‑bill model, Medicare, Tricare, Medicaid, and national and regional commercial payers.
Experience working in Dermatology and/or Oncology is a plus.
Additional Requirements
Proven teamwork and collaboration skills with a demonstrated track record in highly matrixed and cross‑functional teams.
Applies appropriate interpersonal styles and communication methods to influence and build effective relationships with business partners.
Able to effectively manage competing priorities with a strong sense of urgency.
Able to act as an articulate advocate for the market access team.
Provides consistent communication (both positive and negative) and is proactive in conveying information.
Uses appropriate methods and interpersonal styles to develop, motivate, and guide a team toward successful outcomes and attainment of business objectives.
Strong written and verbal communication skills.
Strong presentation skills.
Highly developed analytical skills with demonstrated ability to conceptualize issues and synthesize data to provide strategic direction.
Experience in Sun Pharma’s therapeutic areas: Dermatology, Oncology, Biologics preferred.
Acts as a role model for others in line with Sun’s values.
Compensation & Benefits
The presently‑anticipated base compensation pay range for this position is $155,000 to $185,000. Actual base compensation may vary based on factors, including geographical location and experience. Employees are eligible to participate in company benefit programs, including medical, dental, and vision coverage; life insurance; disability insurance; 401(k) savings plan; flexible spending accounts; and an employee assistance program. Paid time off benefits include vacation time and sick time.
Equal Employment Opportunity
Sun Pharmaceuticals Industries, Inc. (Sun) provides equal employment opportunities for all current employees and applicants for employment. This policy prohibits discrimination based on race, religion, creed, color, national origin, nationality, citizenship, ancestry, sex, age, marital status, physical or mental disability, sexual orientation, veteran status, or any other basis prohibited by law.
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The Field Reimbursement Manager is part of the Market Access group supporting Sun’s family of branded products in the United States. The primary goal of this role is to support appropriate patient access to care by assisting practices, accounts, and providers with reimbursement, specialty pharmacy and distribution processes, provider support services, and patient support resources.
The role monitors national and local healthcare payer policies, develops relationships with key advocacy leaders and state societies, and provides direct support to prescribing physicians, hospitals and support staff regarding reimbursement and product access within payer channels.
Responsibilities
Incorporate knowledge of dynamic marketplace and business trends to deliver maximum access to the portfolio of Sun products.
Deeply understand medical vs pharmacy benefit and policy.
Understand the dynamics of specialty pharmacy and specialty distribution.
Demonstrate a broad understanding of the physician buy‑and‑bill model and assignment of benefits to alternate sites of care.
Identify and establish alternate sites of care that support patient options.
Possess expertise in Medicare policies and variations across Medicare parts.
Ensure clear communication processes with sales teams to address reimbursement and access issues and support pull‑through efforts.
Listen and respond appropriately to customer needs and questions.
Effectively communicate with customers using selling, listening, negotiation skills, proper terminology and approved messaging.
Maintain thorough knowledge of Sun products.
Communicate regularly and timely with manager and support teams as required.
Create a positive impression with customers.
Prepare reports for management as needed.
Participate in teleconference and live national, regional, and district meetings, training sessions, and represent Sun at conventions when requested.
Ensure behaviors consistent with Healthcare Compliance guidelines.
Qualifications
A minimum of a Bachelor’s Degree is required.
Five or more years of healthcare industry experience, including at least three years in areas such as insurance verification, claim adjudication, physician office and outpatient billing, medical benefit procurement, and payer adjudication within commercial and government payers.
Experience with buy‑and‑bill model, Medicare, Tricare, Medicaid, and national and regional commercial payers.
Experience working in Dermatology and/or Oncology is a plus.
Additional Requirements
Proven teamwork and collaboration skills with a demonstrated track record in highly matrixed and cross‑functional teams.
Applies appropriate interpersonal styles and communication methods to influence and build effective relationships with business partners.
Able to effectively manage competing priorities with a strong sense of urgency.
Able to act as an articulate advocate for the market access team.
Provides consistent communication (both positive and negative) and is proactive in conveying information.
Uses appropriate methods and interpersonal styles to develop, motivate, and guide a team toward successful outcomes and attainment of business objectives.
Strong written and verbal communication skills.
Strong presentation skills.
Highly developed analytical skills with demonstrated ability to conceptualize issues and synthesize data to provide strategic direction.
Experience in Sun Pharma’s therapeutic areas: Dermatology, Oncology, Biologics preferred.
Acts as a role model for others in line with Sun’s values.
Compensation & Benefits
The presently‑anticipated base compensation pay range for this position is $155,000 to $185,000. Actual base compensation may vary based on factors, including geographical location and experience. Employees are eligible to participate in company benefit programs, including medical, dental, and vision coverage; life insurance; disability insurance; 401(k) savings plan; flexible spending accounts; and an employee assistance program. Paid time off benefits include vacation time and sick time.
Equal Employment Opportunity
Sun Pharmaceuticals Industries, Inc. (Sun) provides equal employment opportunities for all current employees and applicants for employment. This policy prohibits discrimination based on race, religion, creed, color, national origin, nationality, citizenship, ancestry, sex, age, marital status, physical or mental disability, sexual orientation, veteran status, or any other basis prohibited by law.
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