Access & Reimbursement Manager - NPS Enterprise - South CA - Remote
Company: Sandoz International GmbH
Location: San Diego
Posted on: May 28, 2023
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Job Description:
For 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 isresponsible
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 South California Enterprise Access & Reimbursement Manager is a
remote/field-based role that covers the following major cities, but
not limited to: Los Angeles, San Diego, Palm Springs, Riverside,
Honolulu. Candidate must reside within territory, or within a
reasonable daily commuting distance of 60 miles from territory
border.
The Access & Reimbursement Manager, Enterprise (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 (see below) in support of aligned product(s) strategy. The
NPS Enterprise team may be focused on multiple Therapeutic Areas
and will be deployed according to business needs; but the immediate
Therapeutic Area of focus is Cardiovascular.
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. Additionally, the ARM
will continually need to demonstrate a keen ability to problem
solve, analyze access and reimbursement issues and opportunities,
and proactively communicate changes in the healthcare
landscape.
ARM will 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. ARM 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).
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.
Ability to 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). 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.
Maintain expertise in regional and local access landscape,
anticipating changes in the healthcare
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 HIPPA 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 sites 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.
Customer-facing roles only:
While Novartis does not require vaccination for Covid-19 or proof
of a recent negative test result for Covid-19 at this time,
employees working in customer-facing roles must adhere to and
comply with customers' (such as hospitals, physician offices, etc.)
credentialing guidelines, which may require vaccination. As
required by applicable law, Novartis will consider requests for
reasonable accommodation for those unable to be vaccinated. This
requirement is subject to applicable state and local laws and may
not be applicable to employees working in certain jurisdictions.
Please send accommodation requests to
Eh.occupationalhealth@novartis.com .
Novartis Compensation and Benefit Summary: The pay range for this
position at commencement of employment is expected to be between
$136,800 and $205,200 per year; however, while salary ranges are
effective from 1/1/23 through 12/31/23, fluctuations in the job
market may necessitate adjustments to pay ranges during this
period. Further, final pay determinations will depend on various
factors, including, but not limited to geographical location,
experience level, knowledge, skills and abilities. The total
compensation package for this position may also include other
elements, including a sign-on bonus, restricted stock units, and
discretionary awards in addition to a full range of medical,
financial, and/or other benefits (including 401(k) eligibility and
various paid time off benefits, such as vacation, sick time, and
parental leave), dependent on the position offered. Details of
participation in these benefit plans will be provided if an
employee receives an offer of employment. If hired, employee will
be in an "at-will position" and the Company reserves the right to
modify base salary (as well as any other discretionary payment or
compensation program) at any time, including for reasons related to
individual performance, Company or individual department/team
performance, and market factors.
Diversity & Inclusion / EEO The Novartis Group of Companies are
Equal Opportunity Employers and take pride in maintaining a diverse
environment. We do not discriminate in recruitment, hiring,
training, promotion or other employment practices for reasons of
race, color, religion, gender, national origin, age, sexual
orientation, gender identity or expression, marital or veteran
status, disability, or any other legally protected status. We are
committed to building diverse teams, representative of the patients
and communities we serve, and we strive to create an inclusive
workplace that cultivates bold innovation through collaboration and
empowers our people to unleash their full potential. What You'll
Bring to the Role:
Education:bachelor's degreerequired.Advanced degree preferred.
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)
Superb knowledge of buy-and-bill reimbursement pathway
Experience working with established injection networks
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)
Establishing relationships within a practice by working closely
with them to help remove Reimbursement barriers to specialty
products for their patients
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
Knowledge of Managed Care, Government, and Federal payer sectors,
as well as Integrated Delivery Network/Integrated Health Systems 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?
766 million lives were touched by Novartis medicines in 2021, and
while we're proud of this, we know there is so much more we could
do to help improve and extend people's lives.
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.
We believe our potential can thrive and grow in an unbossed culture
underpinned by integrity, curiosity and flexibility. And we can
reinvent what's possible, when we collaborate with courage to
aggressively and ambitiously tackle the world's toughest medical
challenges. Because the greatest risk in life, is the risk of never
trying!
Imagine what you could do here at Novartis!
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.
Accessibility and Reasonable Accommodations: Individuals in need of
a reasonable accommodation due to a medical condition or disability
for any part of the application process, or to perform the
essential functions of a position, please send an e-mail
totas.nacomms@novartis.com or call +1(877)395-2339 and let us know
the nature of your request and your contact information. Please
include the job requisition number in your message.
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 here: https://talentnetwork.novartis.com/network
Field roles with a dedicated training period only: The individual
hired for this role will be required to successfully complete
certain initial training, including home study, in eight (8) or
fewer hours per day and forty (40) or fewer hours per week.
Keywords: Sandoz International GmbH, San Diego , Access & Reimbursement Manager - NPS Enterprise - South CA - Remote, Executive , San Diego, California
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