Sandoz Pharmaceuticals AG
Access & Reimbursement Manager (ARM) – NPS CV – Baltimore - Remote
Sandoz Pharmaceuticals AG, Baltimore, Maryland, United States, 21276
Access & Reimbursement Manager (ARM) – NPS CV – Baltimore - RemoteFor six decades, we’ve been working to advance cardiovascular health by transforming the standard of care and bringing innovation to areas of high unmet need.
CVD is the #1 cause of death worldwide. In fact, CVD is responsible for more deaths than all cancers combined. And after a decade of decline, the number of deaths is on the rise again. Evidence suggests the pandemic led to the worsening of CV outcomes. This burden is likely to escalate and overwhelm society if we do not make significant changes to curtail the rising incidence. ASCVD accounts for 85% of CVD deaths and addressing key risk factors – such as elevated LDL-C and Lp(a) – can reduce the risk of heart attack and stroke.Job Purpose:The Access & Reimbursement Manager (ARM) 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 in support of aligned product(s) strategy. ARM will serve as the key contact and lead for access and reimbursement support-related matters and is responsible for being the local market access expert on payer policy coverage, multi-channel acquisition pathways, billing and coding, claims processing, reimbursement, and integration of manufacturer support programs into a range of account workflows.Your Key Responsibilities: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.Work with key members of therapeutic area offices (e.g., providers, administrators, billing and coding staff, claims departments, revenue cycle managers) in order to appropriately support patient access to products.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). Identify trends at a local, regional and national level and partner with purpose internally and externally to support patient pull-through.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.Collaborate with aligned cross-functional associates within NPC 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.Minimum 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 in-office support programs.Prior account management experience or prior experience with complex accounts (Payer landscape, high patient volume, large systems).Specialty pharmacy experience required (ability to teach an office the entire process from script to injection).Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Parts B and D (Medical and Pharmacy Benefit design and coverage policy) a plus.Ability to travel and cover large multistate geography territories, at least 50% travel required, based on geography and territory/targeting make up; Must live within assigned territory.Why Novartis?We believe new insights, perspectives and ground-breaking solutions can be found at the intersection of medical science and digital innovation. That a diverse, equitable and inclusive environment inspires new ways of working.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.
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CVD is the #1 cause of death worldwide. In fact, CVD is responsible for more deaths than all cancers combined. And after a decade of decline, the number of deaths is on the rise again. Evidence suggests the pandemic led to the worsening of CV outcomes. This burden is likely to escalate and overwhelm society if we do not make significant changes to curtail the rising incidence. ASCVD accounts for 85% of CVD deaths and addressing key risk factors – such as elevated LDL-C and Lp(a) – can reduce the risk of heart attack and stroke.Job Purpose:The Access & Reimbursement Manager (ARM) 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 in support of aligned product(s) strategy. ARM will serve as the key contact and lead for access and reimbursement support-related matters and is responsible for being the local market access expert on payer policy coverage, multi-channel acquisition pathways, billing and coding, claims processing, reimbursement, and integration of manufacturer support programs into a range of account workflows.Your Key Responsibilities: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.Work with key members of therapeutic area offices (e.g., providers, administrators, billing and coding staff, claims departments, revenue cycle managers) in order to appropriately support patient access to products.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). Identify trends at a local, regional and national level and partner with purpose internally and externally to support patient pull-through.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.Collaborate with aligned cross-functional associates within NPC 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.Minimum 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 in-office support programs.Prior account management experience or prior experience with complex accounts (Payer landscape, high patient volume, large systems).Specialty pharmacy experience required (ability to teach an office the entire process from script to injection).Knowledge of Centers of Medicare & Medicaid Services (CMS) policies and processes with expertise in Medicare Parts B and D (Medical and Pharmacy Benefit design and coverage policy) a plus.Ability to travel and cover large multistate geography territories, at least 50% travel required, based on geography and territory/targeting make up; Must live within assigned territory.Why Novartis?We believe new insights, perspectives and ground-breaking solutions can be found at the intersection of medical science and digital innovation. That a diverse, equitable and inclusive environment inspires new ways of working.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.
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