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Novartis

Novartis is a leading global pharmaceutical and healthcare research and solutions company dedicated to improving patient lives by uncovering solutions to curren

Access & Reimbursement Manager – Immunology

Location

California

Posted

1 day ago

Salary

$138.6K - $257.4K / year

Seniority

Senior

Bachelor Degree3 yrs expEnglish

Job Description

Access & Reimbursement Manager – Immunology

Novartis

• 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).

Job Requirements

  • 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.
  • Ability to operate as a “team player” in collaborating with multiple sales representatives, sales leadership, and internal colleagues to reach common goals.
  • Candidate must reside within territory, or within a reasonable daily commuting distance of 60 miles from the territory border. Ability to travel 60-80% over a broad geography is required , with the ability to drive and/or fly within the territory. Must have a valid driver’s license.

Benefits

  • health, life and disability benefits
  • 401(k) with company contribution and match
  • generous time off package including vacation, personal days, holidays and other leaves

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