Access and Reimbursement Manager (Neph Overlay - West)

Keenova Therapeutics plc; Los Angeles (CA); On-site; USD 121,000 - 194,000; Full time

Benefits offered by this job

Total Rewards package

Bonus eligibility

Job summary

Keenova is hiring an Access and Reimbursement Manager (Neph Overlay - West) in Los Angeles to lead case pull-through and maintain patient access throughout therapy. The role partners with prescribing offices, specialty pharmacies, and the Patient Service Center to accelerate starts and ensure compliant workflows.

The ideal candidate has extensive access/reimbursement experience across multiple specialties, strong analytical and communication skills, and is comfortable traveling up to 60% to

Qualifications

• Minimum 5 years’ experience with specialty pharma products, or 2 years in an access role outside pharma.
• Experience preferred in Ophthalmology, Nephrology, Rheumatology, Pulmonology, Neurology or Dermatology.
• Strong understanding of insurance and benefit design for commercial and government payers.
• Background in Access & Reimbursement, Payer account management, Specialty Pharmacy distribution, Patient Services, Case Management.
• Successful navigation of complex authorization processes for specialty medications.
• Ability to design case-specific strategies with payer mix, benefit design, and authorization requirements.
• Coordinate pull-through with Patient Service Center, Case Managers, Sales and Specialty Pharmacies.
• Educate healthcare offices on best practices to expedite authorization and access.
• Communicate with SPs to improve processing time and shipment scheduling.
• Demonstrated analytical, problem solving and relationship-building skills.
• Excellent communication, organizational and leadership skills.
• Customer interaction and field travel up to 60% – overnights may depend on geography.

Responsibilities

• Lead case pull-through and drive access for patients throughout therapy.
• Work with prescribing offices, Specialty Pharmacies, and Patient Service Center to expedite start of treatment.
• Identify payer trends and develop/tactical plans to maintain treatment access.
• Navigate anti-kickback, fraud and abuse, off-label promotion, and patient assistance program parameters.
• Design case-specific strategies based on payer mix and authorization requirements.
• Coordinate activities with Patient Service Center, Case Managers, Sales, and Specialty Pharmacies.
• Educate HCP offices on best practices to streamline authorization and treatment access.
• Collaborate with SPs to improve processing time and shipment scheduling.

Skills

Access & Reimbursement

Payer account management

Case management

Analytical skills

Communication

Leadership

Relationship building

Field travel

Education

Bachelor’s degree

Job description

Job Title

Access and Reimbursement Manager (Neph Overlay - West)

Requisition

JR000016049 Access and Reimbursement Manager (Neph Overlay - West) (Open)

Location

Los Angeles, CA

Additional Locations

Phoenix, AZ, San Francisco, CA

Job Description Summary

The primary responsibility of the ARM is to help create and maintain treatment access for patients through the duration of the course of therapy. While the sales specialist drives new business demand, the ARM leads the “pull-through” process on open cases by taking compliant actions that improve access and expedite a patient's start to treatment. The ARM facilitates this process by working directly with prescribing offices, contracted Specialty Pharmacies, the Patient Service Center, and sales colleagues.

In addition to leading case “pull-through”, the ARM also identifies payer trends, alerts business partners, and takes initiative around developing, coordinating and executing tactical plans in order to create and maintain treatment access for patients. Due to the ARM’s leadership and access expertise, this individual is viewed by colleagues and customers as a valuable resource that plays a critical role in their success.

The ARM consistently demonstrates uncompromised ethics and integrity while helping others understand legal and regulatory parameters related to anti-kickback statutes, fraud and abuse, off-label promotion, and OIG guidance related to patient assistance programs.

The ideal candidate enjoys working in a fast-paced environment and has the ability to prioritize business needs, solve complex problems, develop strong customer relationships, and motivate others to take appropriate action to move cases forward. The ARM needs to quickly and successfully adapt to evolving and changing business needs.

Job Description

• Minimum of 5 years’ experience working with specialty pharmaceutical products, or minimum of 2 years’ access-related position outside of pharma


• Experience preferred in one or more of the following areas:
  
  
  
  • Ophthalmology
  
  
  • Nephrology
  
  
  • Rheumatology
  
  
  • Pulmonology
  
  
  • Neurology
  
  
  • Dermatology
  
  
  
  


• Strong understanding of insurance and benefit design with both commercial and government payers


• Background in Access & Reimbursement, Payer account management, Specialty Pharmacy distribution, Patient Services, Case Management


• Successful navigation of complex authorization processes for specialty medications


• Working with a Patient Service Center/Hub in order to design case-specific strategies based on payer mix, benefit design, and authorization requirements.


• Coordinating case pull-through with the Patient Service Center, Case Managers, Sales, and Specialty Pharmacies


• Field responsibilities that include supporting and educating HCP offices on best practices that streamline the authorization process and expedite treatment access for patients


• Communicating with SPs to improve processing time and help facilitate shipment scheduling


• Demonstrated analytical, problem solving, and relationship-building skills


• Excellent communication, organizational and leadership skills


• Customer interaction and field travel up to 60% - overnights dependent on geography


• Preferred Location:

Education

• Bachelor’s or higher degree required

Keenova offers employees a Total Rewards package which includes competitive pay and benefits. To learn more about our Total Rewards benefits please visit: Keenova Careers | Serve and Grow with Purpose | Keenova

The expected base pay range for this position is $121K - $194K. Please note that base pay offered may vary depending on factors including job-related knowledge, skills, and experience.

This position is eligible for a bonus in accordance with the terms of the applicable program. Bonuses are awarded at the Company’s discretion.

Disclaimer: The above statements are intended to describe the general nature and level of work performed by employees assigned to this job. They are not intended to be an exhaustive list of all duties, responsibilities, and qualifications. Management reserves the right to change or modify such duties as required.

At Keenova, we believe that no one should be alone in their pursuit of better health. This purpose drives us as we pair quality therapeutics with human support—showing up in big moments and small to help patients find comfort and confidence.

We bring deep expertise and resolve to every therapeutic area we serve, including immunology, urology, men’s health, orthopedics, critical care, and pediatric endocrinology. We work with patients, care partners, and physicians to help them navigate healthcare system complexity and access therapies that make a meaningful difference.

We are Keenova—keen to solve, keen to serve. Learn more at www.keenova.com.