Act as a compliant subject matter expert (SME) in reimbursement, access, and specialty distribution for assigned geography.
Provide education to HCP offices on coverage status, prior authorization processes, appeals, and alternate funding options for uninsured/underinsured patients.
Build and maintain productive relationships with HCPs, office staff, and health system stakeholders.
Analyze regional and local payer coverage trends, reimbursement criteria, and payer mix.
Provide guidance on specialty pharmacy services and help customers navigate complex distribution channels.
Partner with the Patient Support team to ensure accurate benefit investigations and streamlined patient onboarding.
Collaborate with internal partners to build local access strategies aligned with business objectives.
Develop and execute territory-level business plans using strategic customer insights.
Participate in field-based problem-solving, including reimbursement issue resolution and case escalation when needed.
Identify process improvements and innovations to enhance patient access and provider satisfaction.
Maintain compliance with legal, regulatory, and company policies, especially those governing patient privacy and promotional conduct.
Requirements
Bachelor’s degree in an allied health field preferred or equivalent work experience.
8+ years of experience in the pharmaceutical, biotech, or related healthcare industry.
Previous Reimbursement Experience Required: Candidates should have substantial experience with prior authorizations and navigating the US payer landscape.
3–6 years of experience supporting Specialty Pharmaceuticals/Biologics.
Deep understanding of reimbursement, access, and specialty pharmacy operations.
Experience supporting product launches or guiding patients through insurance approval processes.
Strong understanding of Specialty Pharmacy distribution models and patient services programs.
Knowledge of HIPAA and other federal/state laws governing patient confidentiality and healthcare communications.
Bilingual skills are highly desired (English/Spanish).
Proven track record supporting complex therapies in rare or specialty conditions
Exceptional communication and interpersonal skills with the ability to build trust with providers, and internal partners.
Comfort navigating ambiguity, managing multiple cases simultaneously, and solving problems in real time.
Digital fluency with CRM platforms and comfort educating patients on technology-enabled support tools, including AI-based platforms.
Benefits
401(k) plan with company match
Medical, dental, and vision plans
Company-offered Life and Accidental Death & Dismemberment (AD&D) insurance
Company-provided short and long-term disability benefits
Unique offerings of Pet Insurance and Legal Insurance
Employee Assistance Program
Employee Discounts
Professional Development
Health Saving Account (HSA)
Flexible Spending Accounts
Various incentive compensation plans
Accident, Critical Illness, and Hospital Indemnity Insurance
Mental Health resources
Paid leave benefits for new parents
Applicant Tracking System Keywords
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