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Field Reimbursement Manager
hace 2 semanas
Scope of Authority
Endo Branded - Specialty
Key Accountabilities
- Accountability & Responsibilities_
- % of Time_
Provider Account Support
Subject matter expert for all reimbursement/access and acquisition logístical aspects of a high touch biologic medication for an orphan disease and testosterone products with multiple acquisition options within a changing payer landscape. This includes: payer policies, prior authorization requirements, denial and appeal process, peer to peer, and other education required to navigate access for the appropriate patients.
- Assists HCP offices with questions related to Buy/Bill BI management. Educate/Assist with Specialty Pharmacy (SP) understanding, expectations and logistics. Continually educate office staff on appropriate steps, educate on the importance of chart documentation, keep offices up to date on payer policies for Endo products and triage issues to the appropriate HUB and SP.
- Primary responsibilities include:
- o Managing patient assistance and reimbursement support services offered to providers and related to patient access to buy/bill products.
- o Coordinating with Endo’s patient support services program representatives.
- o Educating office staff on the use of Buy/Bill products, patient assistance and reimbursement support services.
- o Participating in sales training related to product reimbursement.
- Utilizing data to critically think through acquisition challenges from a variety of outlets including SP, Specialty Distributors and Title sales.
- Assist new offices from a reimbursement perspective to inform them about reimbursement issues as well as providing education on various MARC approved resources pertaining to reimbursement, acquisition and coding.
- Act in a compliant manner at all times.
- 60%_
- Specialty Pharmacy (SP) Support_
- FRMs work closely with the external and internal customers to trouble shoot any SP related issues. FRMs work closely with their NAE partner to manage any customer related issues directly with the SP’s.
- SP experience is critical. Each FRM should be an expert SP logistics and operations.
- FRMs must be able to analyze data and know how to make that data into actionable steps to facilitate patient access to ENDO products.
- Work closely with SP’s to understand logístical issues that arise and provide MARC approved resources and programs to facilitate patient access as well as communicate with SP’s to find resolutions to issues that arise at the SP.
- Identify gaps in knowledge of accounts from a SP process and help provide education for the account and physician.
- Develop short and long term account plans for key accounts with the goal of smoothing out the process of acquiring drug to optimize acquisition and patient journey
- 10%_
- Internal Partnerships_
- Consistent, reliable, timely and high-quality support of the field, as well as all other internal commercial functions.
- Strong leadership role to the field teams by establishing a solutions oriented approach, working with your Sales Representatives/ASMs to build and execute local plans to overcome barriers to Buy/Bill products access. Specific examples include:
o Identify in conjunction with the field, specific targeted accounts where the FRM will assist with product acquisition or SP dispense.
o Partner with the ASMs to build local business plans; participate in district business reviews as the expert resource on the reimbursement landscape from regional, district, state and local perspective.
o Provide the teams with actionable feedback (across the organization) on support programs such as the Helpline, copay card, SPP performance, so as to guide changes to improve access.
o Help educate the internal customers on managed market dynamics specific to SP’s/SD’s as well as local payor issues-needs. Track customer trends in order to help inform internal business decisions, e.g. Health care policy changes.
o Proactively use business analytics to understand common logístical issues in top accounts and proactively develop plans for education and to find solutions for better patient access to all supported specialty products. Ensure alignment with ASM and District Strategy.
o Provide support to sales representatives, ASMs and Internal Stakeholders on rules of engagement to educate and further clarify what is appropriate.
- 25%_
- Advocacy_
- Works with the field to identify potential payer advocates and supports the National Account Management team on issues relating to medical policy development and execution at the HCP level.
- Ensure all Endo approved promotional speakers have an in-depth understanding of billing/coding, logistics and payer coverage.
- 5%_
- Other duties as assigned.
- Total_
- 100%_
**Qualifications**:
- Education & Experience_
- BS or equivalent is required; MBA or advanced degree preferred.
- 5-7 years of relevant experience in the Biopharma industry required.
- Three years’ experience in 3rd party reimbursement and m
