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Healthcare Businesswomen’s Association

AD, Access & Reimbursement - Minneapolis - Remote

Healthcare Businesswomen’s Association, Minneapolis, Minnesota, United States, 55400


Job Description SummaryLocation: RemoteThe Associate Director, Access & Reimbursement, CRM is a remote/field-based role that covers the following states but not limited to, Minneapolis, Saint Paul, Saint Cloud, & Rochester, Minnesota. The Associate must reside within territory, or within a reasonable daily commuting distance of 60 miles from territory border.The Associate Director, Access & Reimbursement (ADAR) is a field-based role that proactively provides in person (or virtual as needed) education to defined accounts within their assigned geographies on a wide range of access and reimbursement topics and needs (see below) in support of aligned product(s) strategy. ADARs primarily focus on accounts with increased process and workflow complexity, typically including centralized and decentralized systems of care, integrated delivery networks, academic medical institutions, large multi-provider specialty practices, and alternate sites of care.ADARs will serve as the access and reimbursement lead in business-to-business conversations with account executives. The ADAR role is responsible for managing the pull-through of access and reimbursement strategy and downstream operations within their aligned accounts. ADARs 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 integration of manufacturer support programs into a range of account workflows. ADAR will continually need to demonstrate a keen ability to problem solve and manage multiple projects.ADARs partner closely with other Novartis Pharmaceuticals Corporation (NPC) field associates, including Customer Engagement (Sales) and Market Access, representing NPC with the highest integrity in accordance with NPC Values and Behaviors. ADARs will also be required to coordinate and communicate cross-functionally within NPC (e.g., Patient Support Center, Customer Engagement, Marketing, Market Access, Public Affairs, State & Government Affairs, Trade, Specialty Pharmacy Account Management, and other applicable third-party affiliates).Key Responsibilities:Interact with large, complex accounts to support patient access within their aligned therapeutic area product(s), proactively provide face-to-face education on programs to providers and staff in order to support integration of those products into office processes and workflows.Work with key members of therapeutic area offices (e.g., executives, providers, administrators, billing and coding staff, claims departments, revenue cycle managers) in order to appropriately support patient access to products.Ability to analyze problems and offer solutions. Understand specifics and support questions associated with patient reimbursement and coordinate on reimbursement issues with third party payers at the provider-level. 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.Supports pull through on local coverage decisions to enable meaningful patient access within the system. Proactively communicate policy changes or issues that could potentially affect other departments.Maintain expertise in regional and local access landscape, anticipating changes in the healthcare landscape, and act as their aligned therapeutic area product(s) reimbursement expert (as needed).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 HIPAA and other privacy laws and regulations and internal Company compliance guidelines).Buy and Bill Specific:Assess access situation within the assigned geography and develop appropriate Plan of Action (POA). Communicate POA to appropriate personnel.Responsible for establishing preferred acquisition pathways. Educate on and support buy-and-bill end-to-end processes, workflows, and facility pull-through in complex accounts, including scenarios of centralized and decentralized acquisition, and use of alternative channels such as white bagging, clear bagging, brown bagging, and alternate site of care for administration.Educates relevant stakeholders on logistics related to ordering, payment, inventory, and product returns & replacement.Analyze reimbursement issues & opportunities, anticipating changes in the healthcare landscape, and act as the designated reimbursement expert for offices and field teams.Accountable for engagement with non-prescribers, for example pharmacy, system leadership, financial counselors, office administrators, revenue cycle managers, etc.What You’ll Bring to the Role:Education:

Bachelor’s degree required; Business and/or biological science education preferred. Advanced degree preferred.Essential Requirements:5+ Years of experience in pharmaceuticals / biotech industry focused in NPS (Novartis Patient Support), Market Access, Sales, and/or account management. With 2 of those years being in a NPS practice support role for a specialty product(s).Experience working with highly complex practices and/or health systems to establish access and acquisition pathways.Strategic account management experience using a proactive approach to anticipate access hurdles impacting accounts and patient access.Deep expertise and experience integrating manufacturer-sponsored patient support programs.Experience with specialty products acquired through Specialty Pharmacy networks.Knowledge of reimbursement pathways (specialty pharmacy, buy-and-bill, retail)Possess a strong understanding of Commercial payers, Medicare plans and state Medicaid in geographic region.Must live within assigned territory.Ability to travel and cover geography, at least 50% travel required, based on geography and territory / targeting make up.Why Novartis:

Our purpose is to reimagine medicine to improve and extend people’s lives and our vision is to become the most valued and trusted medicines company in the world. How can we achieve this? With our people. It is our associates that drive us each day to reach our ambitions. Be a part of this mission and join us!You’ll Receive:

You can find everything you need to know about our benefits and rewards in the Novartis Life Handbook.Commitment to Diversity & Inclusion:

Novartis is committed to building an outstanding, inclusive work environment and diverse teams representative of the patients and communities we serve.Join our Novartis Network:

If this role is not suitable to your experience or career goals but you wish to stay connected to hear more about Novartis and our career opportunities, join the Novartis Network.

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