Remote Allergy Access & Reimbursement Manager

Novartis; Lexington (KY); Hybrid; USD 139,000 - 257,000; Full time

Job summary

Novartis is seeking an Access & Reimbursement Manager to cover the Louisville, Kentucky geography in a remote and field-based capacity. You will serve as the local market access expert on payer policy coverage, multi-channel acquisition pathways, billing and coding, claims processing, and reimbursement integration into account workflows.

You will partner with NPC teams, manage payer questions, and drive patient access.

Qualifications

• Bachelor’s Degree required. Business and/or biological science education preferred. Advanced degree preferred.
• Minimum three to five years’ experience in public or private third-party Reimbursement arena or pharmaceutical industry in managed care, clinical support, or sales.
• Experience with specialty pharmacy products acquired through Specialty Pharmacy networks or specialty distributors (buy and bill).
• Experience with coding, billing and office support programs.
• Prior account management experience or prior experience with complex accounts (Payer landscape, high patient volume, large systems).
• Knowledge of Managed Care, Government, and Federal payer sectors, as well as Integrated Delivery Network/Integrated Health Systems.

Responsibilities

• Interact within assigned accounts to support patient access within their therapeutic area product(s) providing proactive face-to-face education on product-specific programs to providers and staff in order to support integration of those programs into office processes and workflows.
• Ability to analyze problems and offer solutions. Understand specifics and support questions associated with payer policies (e.g., utilization management, denial, and appeals), drug acquisition and inventory management, and patient / practice reimbursement (e.g., Co-pay, administration, drug claims). Analyze account reimbursement issues & opportunities (as needed). Identifies trends at a local, regional and national level and partner with purpose internally and externally to support patient pull-through.
• Interface with Patient Support Center (hub) on important matters related to patient case management, including tracking cases, issue resolution, reimbursement support, and appropriate office staff education. Review patient-specific information in cases where the site has specifically requested assistance and patient health information is available in resolving any issues or coverage challenges.
• Collaborate with aligned cross-functional associates within NPC (see above) to share insights on customer needs and barriers for their aligned therapeutic area product(s) related to access and reimbursement.
• Maintain a deep understanding of NPC policies and requirements and perform all responsibilities with integrity and in a manner consistent with company guidance and prescribed Values and Behaviors. Handle Patient Identifiable Information (PII) appropriately (understand and ensure compliance with HIPPA and other privacy laws and regulations and internal Company compliance guidelines).

Skills

Reimbursement experience

Account management

Knowledge of Managed Care

Travel readiness

Education

Bachelor’s Degree

Job description

Novartis is seeking an Access & Reimbursement Manager to cover the Louisville, Kentucky geography in a remote and field-based capacity. You will serve as the local market access expert on payer policy coverage, multi-channel acquisition pathways, billing and coding, claims processing, and reimbursement integration into account workflows.

You will partner with NPC teams, manage payer questions, and drive patient access.