Associate Director, Access and Reimbursement (Houston)

TG Therapeutics, Inc.; Houston (TX); On-site; USD 120,000 - 150,000; Full time

Job summary

A leading biopharmaceutical company is seeking an Associate Director for Access and Reimbursement in Houston. This role involves optimizing patient access to therapies and collaborating with healthcare providers. The ideal candidate will have extensive experience in the biopharmaceutical industry, particularly in multiple sclerosis, and will act as a subject matter expert on reimbursement issues. Responsibilities include educating accounts, managing relationships, and addressing reimbursement challenges. This position requires travel and offers a dynamic work environment focused on improving patient outcomes.

Benefits

Medical insurance

Vision insurance

401(k)

Paid maternity leave

Qualifications

• 8-10+ years of biopharmaceutical industry experience in MS.
• Proven experience launching new buy-and-bill products.
• Ability to establish executive relationships in health systems.

Responsibilities

• Collaborate with stakeholders to ensure optimal patient experience.
• Educate MS accounts on TG service offerings through site visits.
• Maintain accurate records of all account activity.

Skills

Communication

Teamwork

Project Management

Education

BS or BA

MBA

Tools

Patient Health Information (PHI)

Utilization Management Tools

Billing and Coding

Job description

Associate Director, Access and Reimbursement (Houston)

Associate Director, Access and Reimbursement (Houston)

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Organizational Overview:

TG Therapeutics is a fully-integrated, commercial-stage, biopharmaceutical company focused on the acquisition, development and commercialization of novel treatments for B-cell diseases. In addition to a research pipeline including several investigational medicines, TG has received approval from the United States Food and Drug Administration (FDA) for BRIUMVI (ublituximab-xiiy) in the US and European Commission.

Position:

The Access & Reimbursement field-based personnel will be integral in helping MS patients and MS provider accounts with gaining access to TG therapies. The individual will have a specified geography and will serve as the primary point of contact for MS accounts. The individual will optimize the experience for both the patient and the account by reviewing operational metrics and assisting with access and reimbursement challenges for patients prescribed TG MS therapies. This individual will educate and support accounts by providing information and education on the MS product/infusion, patient support services, coordinate infusion training, and product access and reimbursement. This role requires residence and travel in Houston.

Key Responsibilities:

• Collaborate with internal and external stakeholders to ensure an optimal patient experience
• Help build trust with MS accounts within specified geography, including private practices, community hospitals, academic hospitals, and infusion sites by acting as a subject matter expert on all aspects of product reimbursement and access coverage for TG product(s).
• Educate MS accounts on TG service offerings through regularly scheduled site visits, Business Reviews, and educational programs.
• Build strategies unique to each Key Account that optimizes the MS patient journey including timely access to TG product fulfilment.
• Maintain a high level of payer and related Managed Markets insights, including benefit structures, payer restrictions, reimbursement mechanisms, the evolving legal and regulatory landscape, health management programs, and product distribution knowledge necessary to accomplish goals.
• Maintain accurate records of all account activity and provide management with regular reporting on reimbursement issues at the customer level.
• Understand and identify the short and long-term strategic vision and objectives within assigned territory.
• Create awareness of TG Patient Support amongst MS accounts
• Act as the subject matter expert on payer reimbursement by educating MS accounts on regional payer coverage issues, coding and billing changes and appropriate claims submission processes.
• Assist with determining coverage and access options available for TG product(s).
• Work with hub and provider office to address payor reimbursement challenges by providing approved materials.
• Partner with Payer Account Team to track payer coverage outcomes.
• Collaborate with hub, Sales and Market Access teams to triage and address reimbursement challenges from customers.
• Prioritize and manage multiple project timelines and deliverables.
• Serve as a TG Patient Support expert by having a thorough understanding of the MS Patient Support Program and its offerings along with payer and reimbursement landscape

Qualifications:

• 8-10+ years of biopharmaceutical industry experience in MS with a proven history of increasing responsibilities and accomplishment
• Proven experience successfully launching new to market buy-and-bill product(s) and resolving difficult access challenges, including utilization management tools, prior authorizations and appeals
• Detailed understanding of the appropriate use of Patient Health Information (PHI) under HIPAA
• Deep understanding of payer landscape for buy and bill products, including but not limited to commercial/private payers, Medicare Part B, Medicaid
• Previous experience working closely with buy-and-bill products. Strong knowledge of biologics and specialty products.
• Account management experience highly preferred (Neurology clinics and hospital systems).
• Subject Matter Expert (SME) in billing and coding in MS product (preferably infusion products)
• Ability to establish and maintain executive relationships (C-Suite and Pharmacy Director) in health systems and Neurology clinics/practices.
• Solid understanding of the current environment and reimbursement trends in community neurology practices, including alternative payment models.
• Superior communication, teamwork, and ability to work in a high matrix environment.
• This position requires travel (50+%); must reside within or near Houston, TX, with travel required to the extended geography.

Education:

• BS or BA required; MBA preferred.
• At least 8+ years’ experience with payer Reimbursement and Pharma patient services programs is required.

TG Therapeutics is an equal employment opportunity employer, and does not discriminate on the basis of race, color, religion, gender, sexual orientation, gender identity or expression, age, disability, national origin, ancestry, genetic information, military or veteran status, pregnancy or pregnancy-related condition or any other protected characteristic.

Seniority level

• Seniority level

  Mid-Senior level

Employment type

• Employment type

  Full-time

Job function

• Job function

  Product Management, Sales, and Business Development

• Industries

  Biotechnology Research and Pharmaceutical Manufacturing

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Inferred from the description for this job

Medical insurance

Vision insurance

401(k)

Paid maternity leave

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