Access and Reimbursement Manager-MS (Multiple Sclerosis)-Texas North- Remote

Novartis Group Companies; United States; Remote; USD 138,000 - 258,000; Full time

Job summary

A leading healthcare company is looking for an Access & Reimbursement Manager to provide education on access and reimbursement strategies within the assigned territories. This remote role requires strong communication skills and a background in managed care and pharmacy products. Ideal candidates will have experience analyzing reimbursement challenges and maintaining compliance with industry standards. This position offers a competitive salary and opportunities for professional growth.

Benefits

401(k)

Paid Time Off

Discretionary Awards

Qualifications

• Minimum three to five years' experience in reimbursement or pharmaceutical industry.
• Experience with specialty pharmacy products or coding and billing processes.
• Strong relationships and communication skills required.

Responsibilities

• Provide education on access and reimbursement to healthcare providers.
• Analyze problems and offer solutions to reimbursement issues.
• Collaborate with internal teams to enhance access to patients.

Skills

Accountability

Account Management

Commercial Excellence

Problem Solving

Customer Engagement

Education

Bachelor's Degree

Advanced Degree

Tools

Salesforce

Excel

PowerPoint

Job description

Overview

Job Description Summary

The Access & Reimbursement Manager, NPS (Novartis Patient Support) Cardiovascular Allentown, PA geography. This is a remote & field-based role that covers assigned geographies; for example, Austin & Dallas, TX. Associates must reside within the territory or within a reasonable daily commuting distance of 60 miles from the territory border. The ARM is a field-based role that proactively provides in person (or virtual as needed) education to defined accounts within their geographies on a wide range of access and reimbursement topics and needs in support of aligned product strategy. The ARM will serve as the key contact and lead for access and reimbursement support-related matters and is responsible for being the local market access expert on payer policy coverage, multi-channel acquisition pathways, billing and coding, claims processing, reimbursement, and integration of manufacturer support programs into a range of account workflows. The ARM will continually demonstrate problem solving, analysis of access and reimbursement issues and opportunities, and proactive communication of changes in the healthcare landscape. The ARM will partner closely with other NPC field associates, including Customer Engagement (Sales) and Market Access, and coordinate cross-functionally within NPC (e.g., Patient Support Center, Marketing, Public Affairs, State & Government Affairs, Trade, Specialty Pharmacy Account Management, and other third-party affiliates).

Job Description

Major Accountabilities

• 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 to integrate those programs into office processes and workflows.
• Address customer questions related to NPC policies on therapeutic area product ordering, payment, inventorying, and product returns & replacement in offices.
• Work with key members of therapeutic area offices (e.g., providers, administrators, billing and coding staff, claims departments, revenue cycle managers) to appropriately support patient access to products.
• Analyze problems and offer solutions; understand payer policies (utilization management, denial, appeals), drug acquisition and inventory management, and patient/practice reimbursement (Co-pay, administration, drug claims). Analyze account reimbursement issues & opportunities and identify local, regional, and national trends; partner internally and externally to support patient pull-through.
• Support pull-through on local coverage decisions to enable meaningful patient access; proactively communicate policy changes or issues that could affect other departments.
• Accountable for standing up NPC-sponsored patient support programs (e.g., Co-pay) to enable patients starting and staying on therapy.
• Maintain expertise in regional/local access landscape, anticipate changes, and act as the aligned therapeutic area product(s) reimbursement expert 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 when requested and available to resolve issues or coverage challenges.
• Collaborate with cross-functional associates within NPC to share insights on customer needs and barriers related to access and reimbursement.
• Maintain a deep understanding of NPC policies and requirements; handle Patient Identifiable Information (PII) with HIPAA compliance and internal guidelines. Report adverse events via established Novartis systems as per applicable processes.

Education

Bachelor's Degree required. Advanced degree preferred.

Minimum Requirements

• Minimum three to five years' experience in public or private third-party reimbursement or pharmaceutical industry in managed care, clinical support, or sales.
• Experience with specialty pharmacy products acquired through Specialty Pharmacy networks or specialty distributors (buy and bill).
• Experience with coding, billing and in-office support programs.
• Prior account management experience or experience with complex 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 within a practice to remove reimbursement barriers to specialty products for patients.
• Knowledge of CMS policies and processes with expertise in Medicare Parts B and D is a plus.
• Knowledge of managed care, government and federal payer sectors, and IDNs/Integrated Health Systems is a plus.
• Ability to operate as a team player with multiple sales representatives, sales leadership, and internal colleagues to reach goals.
• Ability to travel and cover large multistate geography territories; at least 50% travel required based on geography/territory.
• Must live within the assigned territory.

Preferred Qualifications

• Ability to manage multiple products.
• Excellent presentation skills.
• Advanced knowledge of medical insurance terminology.
• Strong teamwork abilities and project management skills.
• Ability to work independently and manage expenses within budgets.
• Strong computer skills (PowerPoint, Excel, Word, CRM like Salesforce).
• Understanding of patient privacy laws including HIPAA and related state laws.
• Strong business acumen and ability to travel with a valid driver e2 80 99s license.

Compensation

Novartis Compensation and Benefit Summary The pay range for this position at commencement of employment is expected to be between $138,600.00 and $257,400.00 per year; however, ranges may be adjusted for market conditions. Final pay determinations depend on factors including location, experience, knowledge, skills, and abilities. The total compensation may include sign-on bonuses, RSUs, discretionary awards, and benefits (401(k), PTO, etc.). At-hill status and potential salary adjustments may occur at any time.

Additional Details

Field roles with a dedicated training period: The individual hired for this role will be required to successfully complete certain initial training, including home study, in eight (8) or fewer hours per day and forty (40) or fewer hours per week.

Driving is an essential function of this role. A fully valid and unrestricted driver e2 80 99s license is required to be qualified for this role. Reasonable accommodations may be provided if they do not eliminate the essential function of driving.

EEO Statement: The Novartis Group of Companies are Equal Opportunity Employers. We do not discriminate in recruitment, hiring, training, promotion or other employment practices for reasons of race, color, religion, sex, national origin, age, sexual orientation, gender identity or expression, marital or veteran status, disability, or any other legally protected status.

Accessibility and reasonable accommodations

The Novartis Group of Companies are committed to providing reasonable accommodation to individuals with disabilities. If you need an accommodation for any part of the application process or to perform essential functions, please email [e-mail] or call [phone] and include the job requisition number.

Salary Range $138,600.00 - $257,400.00

Skills Desired

• Accountability
• Account Management
• Commercial Excellence
• Competitive Intelligence
• Compliance
• CRM (Salesforce)
• Customer Engagement
• Ethics
• Healthcare Sector
• Market Development
• Problem Solving
• Process Knowledge
• Revenue Growth
• Selling Skills
• Team Collaboration
• Value Propositions