Sr. Manager, Access & Reimbursement - (Orlando, FL) - (Orlando, FL) (field based)

Eisai Inc.; United States; On-site; USD 166,000 - 218,000; Full time

Benefits offered by this job

Annual Incentive Plan

Long Term Incentive Plan

Benefits package

Job summary

Eisai US is seeking a motivated Access & Reimbursement Manager to enable patient access to Eisai products. The role operates in the field, coordinating with payers, providers, and health systems to optimize coverage and reimbursement.

You will develop strategies, educate stakeholders, and manage complex access issues across states. Requires a Bachelor's (Master's preferred) with 8+ years in pharma/biotech access or reimbursement, and strong knowledge of Medicare, Medicaid, and commercial payers.

Qualifications

• Bachelor's degree in related field (Master's preferred) with 8+ years of relevant experience in pharma/biotech.
• Previous patient access or reimbursement experience strongly preferred.
• Experience related to distribution, patient support programs, financial assistance, and patient assistance programs.
• Market Access payer and/or patient access support programs experience.
• Experience of the US healthcare system across one or more major payer segments (Medicare, Medicaid, Federal, and Commercial).
• Experience working with medical and pharmacy benefits, coverage policies, and reimbursement.
• Proven performance in earlier role.
• Ability to engage in person with HCPs and other third parties at offices and institutions regularly.
• Credentialing/ vaccination requirements may apply and reasonable accommodation may be requested.
• Possesses a valid driver's license with a clean driving record.

Responsibilities

• Act as the point of contact for assigned customers with patient access and reimbursement needs.
• Identify, triage, and escalate issues to internal/vendor teams and drive resolution.
• Develop strategies to address access and reimbursement needs across customer group/region.
• Create and deliver training programs to the sales force on patient access issues and Eisai programs.
• Track payer trends; develop and execute plans to maintain treatment access for patients.
• Communicate field access/reimbursement information to internal/external stakeholders.
• Educate physicians, office staff, and others on patient access to Eisai products.

Skills

Communication

Cross-functional Influence

Critical Thinking

Business Agility

Industry & Regulatory (Market Access)

Mentoring/ People Development

Project Management

Reimbursement Knowledge Eisai

Education

Bachelor's degree

Job description

At Eisai, satisfying unmet medical needs and increasing the benefits healthcare provides to patients, their families, and caregivers is Eisai’s human health care (hhc) mission. We’re a growing pharmaceutical company that is breaking through in neurology and oncology, with a strong emphasis on research and development. Our history includes the development of many innovative medicines, notably the discovery of the world's most widely-used treatment for Alzheimer’s disease. As we continue to expand, we are seeking highly-motivated individuals who want to work in a fast-paced environment and make a difference. If this is your profile, we want to hear from you.

The Access and Reimbursement Manager (ARM) will provide appropriate support for patient access to prescribed Eisai products, including through communication with healthcare professionals about insurance coverage and reimbursement for Eisai products and Eisai’s patient support programs. In the event of an access or reimbursement issue, this role will quickly identify and triage, as needed, the situation to appropriate internal or external Eisai partners and manage the communication until appropriate resolution. This role will have a keen understanding of payer coverage at the customer and regional level and strong communication skills to appropriately educate on payer policies. This role will support the Neurology business unit, providing compliant access and reimbursement education to support an Eisai Alzheimer’s product that will necessitate an understanding of buy-and-bill, miscellaneous J Code billing and specialty distribution procurement. The ARM role will be a field-based individual contributor reporting into the Eisai Access and Reimbursement team under Patient Services/Market Access. Working closely with and reporting to the Associate Director, Access and Reimbursement, the ARM, will be the functional lead for Access and Reimbursement activities across HCP offices, alternate sites of infusion care, State Societies, and Health Systems/institutions.

Key External Stakeholders: Health Care Professionals and stakeholders responsible for physician reimbursement and patient coverage and access issues. These stakeholders include, but are not limited to the following: Practice Mangers, Financial Counselors, Pharmacy Managers/Directors, Business Administrators, State Societies, C and D Suite Health System personnel, and revenue cycle/integrity stakeholders.

Responsibilities

• Act as the point of contact for assigned customers with patient access and reimbursement needs/challenges to provide relevant education and support.
• Identify, triage, and escalate customer issues to relevant internal/vendor teams as required, and drive resolution.
• Develop strategies to address access and reimbursement needs across assigned customer group/region.
• Create and deliver high-level training programs to the sales force (e.g., general information on patient access issues, Eisai patient support programs, separation between sales and access/reimbursement).
• Proactively track payer trends; develop, coordinate, and execute plans to create and maintain treatment access for patients based on analyses of trends and information.
• Communicate current and pertinent field access/reimbursement information (e.g., customer feedback, payer coverage -medical/pharmacy benefit, access to product procurement, payer updates) to relevant internal/external stakeholders.
• Educate external stakeholders (e.g., physicians, office administrators, case managers, financial counselors, medical directors, billing personnel, pharmacists) as appropriate, on matters related to patient access to Eisai products.

Qualifications

• Bachelor's degree in related field (Master's preferred) with 8+ years of relevant experience in pharma/biotech industry.
• Previous patient access or reimbursement experience strongly preferred.
• Experience related to distribution, patient support programs, financial assistance, and patient assistance programs.
• Market Access payer and/or patient access support programs experience.
• Experience of the US healthcare system across one or more major payer segments (Medicare, Medicaid, Federal, and Commercial).
• Experience working with medical and pharmacy benefits, coverage policies, and reimbursement.
• Proven performance in earlier role.
• As a condition of employment and an essential function of this field-based position, applicants must be able to engage in person with HCPs and other third parties at their offices, institutions and other appropriate locations on a regular basis.
• In order to gain in-person access, applicants selected for the position may be required to complete third parties’ credentialing and/or entry requirements, which often include an attestation to and/or providing proof of having received certain vaccinations.
• To the extent you are unable to meet certain requirements for qualifying medical (including pregnancy-related) or religious reasons, applicants must request a reasonable accommodation by contacting the Human Resources Department.
• Possesses and maintains a valid driver’s license and clean driving record Ability to operate a motor vehicle safely and successfully is required.

Skills

• Communication & Cross-functional Influence
• Critical Thinking & Business Agility
• Industry & Regulatory (Market Access)
• Mentoring/ People Development
• Project Management
• Reimbursement Knowledge Eisai

Eisai Salary Transparency Language

The annual base salary range for the Sr. Manager, Access & Reimbursement - (Orlando, FL) - (Orlando, FL) (field based) is from :$166,000-$217,900. Under current guidelines, this position is eligible to participate in : Eisai Inc. Annual Incentive Plan & Eisai Inc. Long Term Incentive Plan. Final pay determinations will depend on various factors including but not limited to experience level, education, knowledge, and skills. Employees are eligible to participate in Company employee benefit programs. For additional information on Company employee benefits programs, visit https://careers.eisai.com/us/en/compensation-and-benefits. Certain other benefits may be available for this position, please discuss any questions with your recruiter.

Eisai is an equal opportunity employer and as such, is committed in policy and in practice to recruit, hire, train, and promote in all job qualifications without regard to race, color, religion, gender, age, national origin, citizenship status, marital status, sexual orientation, gender identity, disability or veteran status. Similarly, considering the need for reasonable accommodations, Eisai prohibits discrimination against persons because of disability, including disabled veterans. Eisai Inc. participates in E-Verify. E-Verify is an Internet based system operated by the Department of Homeland Security in partnership with the Social Security Administration that allows participating employers to electronically verify the employment eligibility of all new hires in the United States. Please click on the following link for more information: Right To Work E-Verify Participation At Eisai Inc., human health care (hhc) is our goal. We give our first thoughts to patients and their families, and helping to increase the benefits health care provides.

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