Access and Reimbursement Manager (San Francisco/Sacramento)

Keenova Therapeutics plc; Sacramento (CA); Hybrid; USD 132,000 - 211,000; Full time

Job summary

Keenova Therapeutics plc is seeking an Access and Reimbursement Manager to drive treatment access from initial contact through start of therapy in the San Francisco/Sacramento area.

The role requires deep knowledge of payer design, authorization processes, and collaboration with Patient Service Center, SPs, and sales teams. Expect up to 60% field travel and a high-change, fast-paced environment.

Qualifications

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

Responsibilities

• Lead pull-through on open cases with compliant actions to improve access and expedite treatment start.
• Coordinate with prescribing offices, Specialty Pharmacies, Patient Service Center, and sales colleagues.
• Identify payer trends and develop tactical plans to create and maintain treatment access.
• Design case-specific strategies with Patient Service Center, Case Managers, and Sales.
• Educate HCP offices on best practices that streamline authorization and expedite access.
• Communicate with SPs to improve processing time and shipment scheduling.

Skills

Access & Reimbursement

Payer account management

Specialty Pharmacy distribution

Patient Services

Case Management

Analytical skills

Communication skills

Education

Bachelor’s or higher degree

Job description

Job TitleAccess and Reimbursement Manager (San Francisco/Sacramento)RequisitionJR000016050 Access and Reimbursement Manager (San Francisco/Sacramento) (Open)LocationSan Francisco, CAAdditional LocationsSacramento, CAJob Description SummaryThe 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 DescriptionQualifications:Minimum of 5 years’ experience working with specialty pharmaceutical products, or minimum of 2 years’ access-related position outside of pharmaExperience preferred in one or more of the following areas:OphthalmologyNephrologyRheumatologyPulmonologyNeurologyDermatologyStrong understanding of insurance and benefit design with both commercial and government payersBackground in Access & Reimbursement, Payer account management, Specialty Pharmacy distribution, Patient Services, Case ManagementSuccessful navigation of complex authorization processes for specialty medicationsWorking 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 PharmaciesField responsibilities that include supporting and educating HCP offices on best practices that streamline the authorization process and expedite treatment access for patientsCommunicating with SPs to improve processing time and help facilitate shipment schedulingDemonstrated analytical, problem solving, and relationship-building skillsExcellent communication, organizational and leadership skillsCustomer interaction and field travel up to 60% - overnights dependent on geographyPreferred Location:Education:Bachelor’s or higher degree requiredKeenova 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 | KeenovaThe expected base pay range for this position is $132K - $211K. 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.