Access & Reimbursement Manager-NPS- MS-Carolinas-Remote

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

Job summary

An established industry player seeks a proactive Access & Reimbursement Manager to enhance patient access across multiple states. This remote role involves educating healthcare accounts on reimbursement processes, collaborating with cross-functional teams, and analyzing access issues. With a focus on patient support and compliance, the ideal candidate will leverage their expertise in managed care and reimbursement to drive successful outcomes. Join a dynamic team committed to improving patient access and making a meaningful impact in the healthcare landscape.

Qualifications

• 3-5 years of experience in reimbursement or managed care.
• Strong understanding of buy-and-bill reimbursement pathways.

Responsibilities

• Support patient access by educating accounts on product programs.
• Analyze problems related to payer policies and offer solutions.

Skills

Reimbursement Knowledge

Problem Solving

Communication Skills

Clinical Support

Sales Experience

Education

Bachelor's Degree

Advanced Degree

Tools

CMS Policies Knowledge

Specialty Pharmacy

Billing and Coding

Job description

Job Description Summary

The Access & Reimbursement Manager, NPS (Novartis Patient Support) MS (Multiple Sclerosis) is a remote & field-based role covering North Carolina, South Carolina, Southern GA, and Northern Florida. The candidate must reside within the territory or within a reasonable commuting distance of 60 miles from the territory border.

The Access and Reimbursement Manager (ARM) proactively provides in-person (or virtual as needed) education to accounts within their assigned regions on access and reimbursement topics, supporting the product strategy.

ARM serves as the primary contact for access and reimbursement support, acting as the local market access expert on payer policies, acquisition pathways, billing and coding, claims processing, reimbursement, and support programs integration into account workflows. The role requires problem-solving, analyzing access issues, and communicating healthcare landscape changes.

ARM partners with NPC field associates, including Customer Engagement and Market Access, and coordinates cross-functionally within NPC, including Patient Support Center, Marketing, Public Affairs, and third-party affiliates.

Key Responsibilities:

1. Support patient access by engaging with accounts and providing education on product programs to providers and staff, integrating these into office workflows.
2. Address customer questions related to NPC policies on ordering, payment, inventory, and returns.
3. Collaborate with office staff (providers, billing, claims) to support patient access.
4. Analyze problems and offer solutions related to payer policies, drug acquisition, inventory, and reimbursement, identifying trends and supporting pull-through efforts.
5. Support local coverage decisions and communicate policy changes affecting patient access.
6. Implement NVS-sponsored patient support programs to facilitate therapy initiation and adherence.
7. Maintain expertise in regional access landscape, anticipating healthcare changes, and act as reimbursement expert for therapeutic area products.
8. Coordinate with Patient Support Center on case management, issue resolution, and staff education, reviewing patient information as needed.
9. Share insights on customer needs and barriers with cross-functional teams.
10. Ensure compliance with policies, handling patient information appropriately, and reporting adverse events per process.

Qualifications:

• Bachelor's Degree required; advanced degree preferred.
• 3-5 years of experience in reimbursement, managed care, clinical support, or sales within pharma or healthcare.
• Experience with specialty pharmacy, coding, billing, and complex account management.
• Knowledge of CMS policies (Medicare Parts B & D), managed care, and federal payers is a plus.
• Ability to travel up to 50%, with residence within the assigned territory.
• Valid driver’s license required; driving is an essential function.
• Strong understanding of buy-and-bill reimbursement pathways.

Compensation & Benefits:

Starting salary between $138,600 and $257,400/year, with potential bonuses, stock units, and benefits, subject to market and experience.

Additional Information:

Role includes initial training, with travel required. The company provides accommodations for medical restrictions that do not eliminate essential functions.

EEO Statement: We are an equal opportunity employer, committed to diversity and inclusion.

Reasonable accommodations are available for applicants with disabilities. Contact [e-mail] or call [phone], including the job requisition number.