Access & Reimbursement Manager, CV
Novartis
SFDC
Access & Reimbursement Manager, Cardiovascular
Kerr Dental
full-time
Posted on:
Origin: • 🇺🇸 United States • Iowa
Visit company websiteSalary
💰 $138,600 - $257,400 per year
Job Level
Mid-LevelSenior
Tech Stack
SFDC
About the role
- Field-based role providing in-person or virtual education to accounts on access and reimbursement topics
- Serve as key contact and lead for access and reimbursement support-related matters for aligned product(s)
- Act as local market access expert on payer policy coverage, acquisition pathways, billing and coding, claims processing, reimbursement, and integration of manufacturer support programs
- Problem-solve and analyze access and reimbursement issues and proactively communicate changes in the healthcare landscape
- Partner closely with Novartis Pharmaceuticals field associates (Customer Engagement, Market Access) and coordinate cross-functionally (Patient Support Center, Marketing, Public Affairs, State & Government Affairs, Trade, Specialty Pharmacy Account Management)
- Interact with providers, administrators, billing and coding staff, claims departments, revenue cycle managers to support patient access
- Address customer questions related to ordering, payment, inventorying, product returns & replacement
- Analyze account reimbursement issues and identify trends at local, regional and national levels
- Stand up NVS-sponsored patient support programs and interface with Patient Support Center on case management and issue resolution
- Handle Patient Identifiable Information (PII) appropriately and report adverse events per Novartis processes
- Buy-and-bill responsibilities: assess access, develop and communicate Plan of Action, establish preferred acquisition pathways, educate on ordering/payment/inventory/logistics, and support facility pull-through
Requirements
- Bachelor’s Degree required; 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)
- Specialty pharmacy experience required (ability to teach an office the entire process from script to injection)
- Experience with coding, billing and in office support programs
- Prior account management experience or prior experience with complex accounts (Payer landscape, high patient volume, large systems)
- Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes; expertise in Medicare Parts B and D a plus
- Knowledge of Managed Care, Government, and Federal payer sectors, and Integrated Delivery Network/Integrated Health Systems a plus
- Ability to travel and cover large multistate geography territories, at least 50% travel required
- Must live within the territory or within a reasonable daily commuting distance (up to 60 miles) from the territory border
- Fully valid and unrestricted driver’s license required; driving is an essential function
- Good driving record
- Ability to schedule individual work-related travel (air, hotel, rental car as needed)
- Superb knowledge of buy-and-bill reimbursement pathway
- Experience working with established injection networks
- Above average computer skills: PowerPoint, Excel, Word, CRM (Salesforce.com)
- Understanding of patient privacy laws including HIPAA and similar state laws
- Ability to operate as a team player and work independently
- Project management, presentation, and expense management skills
- Company will not sponsor visas for this position
