Senior Field Reimbursement Manager - Upper Midwest Region

Gilead Sciences, Inc.; California (MO); Remote; USD 143,000 - 186,000; Full time

Job summary

An established industry player is seeking a Senior Field Reimbursement Manager to enhance patient access to vital therapies. This role involves building relationships with healthcare providers and specialty pharmacies, providing education on reimbursement processes, and managing strategies to streamline patient access. The ideal candidate will possess deep expertise in the reimbursement landscape and a passion for making a difference in patients' lives. Join a team dedicated to creating innovative solutions for life-threatening diseases and help drive impactful change in the healthcare industry.

Benefits

Discretionary Annual Bonus

Stock-based Long-term Incentives

Paid Time Off

Medical Insurance

Dental Insurance

Vision Insurance

Life Insurance

Qualifications

• 10+ years of experience in field reimbursement or related roles.
• Strong understanding of payer policies and reimbursement processes.

Responsibilities

• Manage relationships with key account stakeholders and providers.
• Educate on reimbursement processes and optimize patient access.

Skills

Relationship Management

Communication Skills

Problem Solving

Strategic Planning

Project Management

Education

Bachelor's Degree

Master's Degree

PhD

Tools

Data Portals

Triaging Apps

Job description

Senior Field Reimbursement Manager - Upper Midwest Region

Senior Field Reimbursement Manager - Upper Midwest Region

Apply locations United States - Illinois - Chicago, United States - Colorado - Denver, United States - Kansas - Kansas City, United States - Minnesota - Minneapolis, United States - Wisconsin - Milwaukee

Time type: Full time

Posted on: Posted 2 Days Ago

Job requisition id: R0044974

At Gilead, we’re creating a healthier world for all people. For more than 35 years, we’ve tackled diseases such as HIV, viral hepatitis, COVID-19, and cancer – working relentlessly to develop therapies that help improve lives and to ensure access to these therapies across the globe. We continue to fight against the world’s biggest health challenges, and our mission requires collaboration, determination, and a relentless drive to make a difference.

Every member of Gilead’s team plays a critical role in the discovery and development of life-changing scientific innovations. Our employees are our greatest asset as we work to achieve our bold ambitions, and we’re looking for the next wave of passionate and ambitious people ready to make a direct impact.

We believe every employee deserves a great leader. People Leaders are the cornerstone to the employee experience at Gilead and Kite. As a people leader now or in the future, you are the key driver in evolving our culture and creating an environment where every employee feels included, developed and empowered to fulfill their aspirations. Join Gilead and help create possible, together.

Job Description

Gilead's mission is to discover, develop, and deliver therapies that will improve the lives of patients with life-threatening illnesses worldwide. The Senior Manager (SM) Field Reimbursement Manager (FRM) will be part of a team that is changing the world and helping millions of people live healthier, more fulfilling lives. The SM FRM is a critical front-line member of the Gilead Field Reimbursement Team. The primary purpose of this role is to serve as a field-based, product access specialist that partners with provider organizations to optimize patient access to Gilead PBC/Liver products, develop impactful relationships, and provide appropriate reimbursement support to HCPs and office staff.

The person in this role proactively provides in-person and virtual education to defined accounts within their assigned regions on a wide range of access and reimbursement topics for aligned portfolio product(s). The SM FRM will primarily focus on accounts serving large volumes of patients needing access support. The SM FRM will also take a pivotal role in building relationships with key accounts to offer patient support.

The person in this role is responsible for managing the pull-through of access and reimbursement strategy within their assigned accounts. SM FRMs are expected to have deep expertise in communicating requirements and addressing barriers associated with local payer policy coverage, multi-channel acquisition pathways, billing and coding (as needed), claims processing, reimbursement, and awareness of manufacturer support programs into a range of account workflows. FRMs will continually need to demonstrate a keen ability to problem-solve and manage multiple projects.

Internal stakeholders with whom the SM FRM will interact include other Gilead field associates, such as Therapeutic Specialists (Sales), representing Gilead with the highest integrity in accordance with Gilead Values and Behaviors. The SM FRM will also be required to coordinate and communicate cross-functionally within the organization (e.g., Patient Support, Marketing, Public Affairs, Government Affairs, Trade, and other applicable third-party affiliates).

The position is a remote/field-based role that covers the Upper Midwest Region (IL, WI, MN, ND, SD, WY, NE, IA, KS, CO). Candidate must reside within 10 miles of their region’s borders.

Specific job responsibilities:

• Develop and manage business relationships with key account stakeholders such as providers and specialty pharmacies and their employees.
• Serve as a regional reimbursement expert, using influence mapping to better identify key customer accounts and reach the right stakeholders.
• Assist internal patient support program team in identifying ways to positively enhance hub & FRM processes, with accompanying internal and external change management. Examples include: streamlining the benefit verification process and educating on prior authorizations to initiate patients on treatments faster. Oversee processes for providers to enroll patients in Gilead patient support programs. Work directly with case managers to resolve complex patient access questions in a timely manner.
• Proactively communicate changes that may arise in the formulary or reimbursement processes for Gilead products and ensure accounts are supported. Provide education on reimbursement processes and requirements such as medical exception and prior authorization.
• Partner with internal stakeholders to design instructional resources for the FRM team to share with providers and their office staff to educate on best practices in reimbursement processes. Communicate local and state policy changes that could cause pitfalls/bottlenecks from a reimbursement standpoint. Field pulse check surveys to understand customer perceptions of Gilead reimbursement support.
• Increase coordination with Gilead HUB by streamlining communication channels between FRMs and case managers. Collaborate closely with internal matrix partners to provide focused, efficient, and impactful customer experiences across the field-team. Help develop policies around communication best practices.
• Identify stages in the Gilead patient journey causing bottlenecks that prevent application of therapies. Employ technology tools (such as triaging apps and data portals) to respond quickly to high-need cases that are brought up the chain of command.

Basic Qualifications:

• Bachelor's Degree and 10 Years' Experience OR
• Master's Degree and 8 Years' Experience OR
• PhD and 2 Years' Experience

Preferred Qualifications:

• BA/BS/RN with 9+ years of experience working for a major pharmaceutical organization on the field reimbursement team.
• MA/MS/PharmD with 7+ years of experience working for a major pharmaceutical organization on the field reimbursement team.
• Prior leadership experience is strongly preferred.
• Deep understanding of relationship between payers, providers, and pharma companies in the reimbursement process.
• Experience engaging with and managing large, complex provider accounts.
• Familiarity with pharmacy benefit, specialty payer landscape, and reimbursement pathways (commercial, Medicare, Medicaid).
• An understanding of local and state policy changes affecting reimbursement policies.
• Preferably have experience with specialty pharmacies and utilizing a HUB service.
• A willingness to travel 75% of the time across the designated region. This is a field-based role where in-person meetings with key stakeholders are crucial to success.

People Leader Accountabilities:

• Create Inclusion - knowing the business value of diverse teams, modeling inclusion and embedding the value of diversity in the way they manage their teams.
• Develop Talent - understand the skills, experience, aspirations, and potential of their employees and coach them on current performance and future potential. They ensure employees are receiving the feedback and insight needed to grow, develop and realize their purpose.
• Empower Teams - connect the team to the organization by aligning goals, purpose, organizational objectives and holding to account. They provide the support needed to remove barriers and connect their team to the broader ecosystem.

The salary range for this position is: $143,225.00 - $185,350.00. Gilead considers a variety of factors when determining base compensation, including experience, qualifications, and geographic location. These considerations mean actual compensation will vary. This position may also be eligible for a discretionary annual bonus, discretionary stock-based long-term incentives (eligibility may vary based on role), paid time off, and a benefits package. Benefits include company-sponsored medical, dental, vision, and life insurance plans.

For additional benefits information, visit: https://www.gilead.com/careers/compensation-benefits-and-wellbeing

* Eligible employees may participate in benefit plans, subject to the terms and conditions of the applicable plans.

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About Us

Gilead Sciences, Inc. is a biopharmaceutical company that has pursued and achieved breakthroughs in medicine for more than three decades, with the goal of creating a healthier world for all people. The company is committed to advancing innovative medicines to prevent and treat life-threatening diseases, including HIV, viral hepatitis, and cancer. Gilead operates in more than 35 countries worldwide, with headquarters in Foster City, California.