Field Reimbursement Manager, California

Recordati; California; A distancia; USD 110.000 - 170.000; Jornada completa

Descripción de la vacante

Recordati Rare Diseases, Inc. (RRD) seeks a Field Reimbursement Manager to lead access initiatives across a US region, focusing on endocrinology therapies.

You will educate healthcare providers on policies, prior authorization, coding and billing and collaborate with specialty pharmacies to minimize barriers to therapy. The successful candidate has 5–7 years in healthcare/pharma, 3+ years in field reimbursement, and experience with buy-and-bill or specialty networks.

Formación

• Bachelors degree required.
• 57 years in healthcare/pharma field.
• 3+ years field reimbursement experience.
• 2+ years with buy-and-bill or specialty networks.

Responsabilidades

• Lead territory reimbursement strategy with cross-functional teams.
• Educate HCPs on policies, prior authorizations, coding and billing.
• Support buy-bill/specialty pharmacy access and reduce barriers to therapy.
• Provide case-specific guidance for appeals after denials.
• Collaborate with stakeholders to manage accounts and travel as needed.
• Monitor payer trends and inform internal stakeholders.

Conocimientos

Relationship-building

Planning & organization

Microsoft Office

Ethical standards

Problem-solving

Prioritization

Communication skills

Educación

Bachelors degree

Descripción del empleo

At Recordati, we are united by a clear purpose: unlocking the full potential of life. With a century of history behind us, we are building the next chapter of our journey, continuing to grow while keeping patients at the centre of all we do.

What drives us is a shared belief that health, and the opportunity to live life to the full, should be within reach for everyone. This brings energy to our work, shaping how we support each other and show up every day. Our values – Better Together, Never Settle and Always Deliver – reflect this mindset, helping us to keep improving and make a meaningful difference.

Above all, these values bring to life our promise to everyone at Recordati, you can unlock your full potential. We know that people thrive when they can be themselves, are trusted and supported, and are given the opportunity to grow and make a meaningful contribution.

Are you ready to unlock your full potential?

This position is with Recordati Rare Diseases, Inc. (RRD), North America, an affiliate of Recordati.

Recordati Rare Diseases, Inc. (RRD) develops high-impact therapies for devastating rare diseases, focusing on providing often overlooked treatments to underserved communities in the U.S. Our mission is to mitigate the impact of rare diseases through increased awareness, improved diagnoses, and enhanced treatment availability, covering endocrinology, metabolic, and oncology franchises. RRD is dedicated to excellence, fostering a dynamic work environment that promotes professional growth and a significant impact on patients' lives.

Reporting Structure

Reports To: Associate Director, Field Reimbursemenet
Direct Reports: None
Areas Managed: Field Reimbursement

Overview

The Field Reimbursement Manager (FRM) will be responsible for managing accounts in a specified region focusing on but not limited to Endocrinology. The FRM is responsible for providing access and reimbursement education to healthcare providers (HCPs)and office personnel, including information regarding medical policies, prior authorization requirements, coding and billing, product access via buybill or specialty pharmacy with the goal of minimizing barriers to therapy. The FRM also supports by providing general education and case-specific next steps for appeals process in response to prior authorization denials. This role involves investing time on-site with HCPs, assessing their access and reimbursement needs education needs and facilitating collaboration with various stakeholders.

Key Responsibilities

• Partnering with cross-functional parties on overall account and territory strategy to maximize
  internal/external customer knowledge on payor policy and processes
• Serve as subject matter experts on issues of coverage, access and reimbursement by providing
  compliant, limited support to US health care providers (HCPs) and their office staff in navigating thereimbursement landscape for products of Recordati Rare Diseases Inc. (RRD) after the HCP made anindependent decision to prescribeCollaborate with HCP staff and Specialty Pharmacy to follow up withaccounts that have outstanding prior authorization or appeals submissions
• Being a subject matter expert on reimbursement and regional-specific access landscape. This includespayor policies, prior authorization requirements, denials, appeals, peer to peer and other educationrequired to navigate access for coverage of company therapies
• Collaborating with cross-functional parties on individual case management needs related to HCPeducation on reimbursement issues
• Collect field insights on payer trends, reimbursement challenges and provider needs to inform internalstakeholders
• Leveraging all available resources including internal data to develop and execute account plans/callpurpose
• Complying with all laws, regulations and policies that govern the conduct of company activities, workwith the highest degree of professionalism and in accordance with the company’s code of Ethics andBusiness Conduct
• Complying with annual budget allocation within respective territory to Perform additional duties as maybe assigned

Education and Experience

• Bachelor’s degree
• Experience in working in field-based role working with provider offices and/or with patient support HUBservices
• Minimum of five to seven years of experience in the healthcare and/or pharmaceutical industry
• Minimum of three years successful field reimbursement experience
• Minimum of two years of experience working with buy and bill and/or specialty pharmacy networks
• Ability to analyze and interpret regulations and legislation regarding coding, coverage andreimbursementsIn-depth knowledge of the U.S. pharmaceutical market, specifically rare diseases.
• Reimbursement or relevant managed care experience (buy-and-bill, prior authorization, coding, andappeals processes)
• Problem-solving ability to navigate challenging access scenarios and identifies solutions in a timely andefficient manner
• Comfortable presenting in person or virtual to Healthcare practitioner office staff
• Superior communication skills (written and verbal) and efficient follow-through

Knowledge and Skills

• Strong relationship-building skills, with demonstrated ability to collaborate and operate across
  functions
• Strong planning and organizational skills; demonstrated decision-making abilityReliable transportation within territory
• Proficiency in Microsoft Office
• Demonstrated highest ethical standards
• Demonstrated effective problem-solving and decision-making capabilities
• Ability to prioritize/multi-task effectively
• Excellent verbal and written communication skills

This job operates in a professional remote environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. Based upon job requirements, the employee is required at times to travel to HCP offices offices within a specified territory and attend meetings including travel out of state over weekends and nights. The employee must be able to freely operate and travel by car and train/plane modes of transportation. The employee is required to have a valid driver’s license and means of transportation.

Physical Demands

The physical demands described here are representative of those required to successfully perform the essential functions of this position. The employee must be able to travel domestically and internationally, as business needs require. This position is primarily sedentary. The employee may occasionally move throughout office, meeting, or event locations and regularly operate a computer, telephone, and other office productivity equipment. The employee must be able to communicate effectively with internal and external stakeholders. Occasionally, the employee may be required to move or transport items weighing up to 25 pounds, with or without accommodations.

Location/Travel

This position is a remote position with proximity to a major airport This position requires approximately 30-40% travel (need based).

FLSA Classification

This position is considered Exempt.

EEO Statement

It is the policy of Recordati Rare Diseases to provide equal employment opportunity (EEO) to all persons regardless of race, color, religion, sex, sexual orientation, gender identity, or national origin. Further, Recordati Rare Diseases will not discriminate on the basis of any characteristic protected by federal, state, or local law. Recordati Rare Diseases will provide reasonable accommodations for a qualified individual with disabilities.

Disclaimer

This job description is not designed to cover or contain a comprehensive listing of the activities, duties or responsibilities that may be required

At Recordati we believe in people! Inspired by our purpose - unlocking the full potential of life - we are committed to creating a diverse environment and cultivating a culture of inclusion. We strive to continually lead with our values and beliefs, enabling our employees to bring their whole selves to work and develop their potential.

We are proud to be an equal opportunity employer. We recruit, develop and reward without regard to, amongst others, gender, sexual orientation, gender identity or expression, national origin, age, physical or mental ability, race, ethnicity, political or religious belief.