Access and Reimbursement Manager, Cardiovascular - Louisville, KY Territory - Remote

Role Summary

Access and 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 strategy. ARM serves as 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 account workflows. The role requires problem solving, analysis of access and reimbursement issues, and proactive communication of changes in the healthcare landscape.

The ARM will partner with NPC field associates and coordinate cross-functionally within NPC. This remote and field-based role covers locations in the Indiana territory, including Louisville, KY; Evansville, IN; Bowling Green, KY; Paducah, KY. The associate must reside within the territory or within a reasonable daily commuting distance (up to 60 miles) from the territory border.

Responsibilities

• Interact within assigned accounts to support patient access within their therapeutic area products, providing proactive face-to-face education on product-specific programs to providers and staff to integrate those programs into office processes and workflows.
• Address customer questions related to NPC policies on product ordering, payment, inventory, and returns in offices.
• Collaborate with key members of therapeutic area offices to support patient access to products.
• Analyze problems and offer solutions related to payer policies, drug acquisition and inventory management, and patient/practice reimbursement; identify reimbursement trends and partner internally/externally to support patient pull-through.
• Support pull-through on local coverage decisions to enable meaningful patient access; communicate policy changes or issues affecting other departments.
• Stand up NPC-sponsored patient support programs to enable patients starting and staying on therapy (e.g., Co-pay).
• Maintain expertise in regional/local access landscape and act as the reimbursement expert for aligned products as needed.
• Interface with the Patient Support Center on patient case management matters, including tracking cases, resolution, reimbursement support, and staff education; review patient-specific information as requested.
• Collaborate with cross-functional NPC teams to share insights on customer needs and barriers related to access and reimbursement.
• Maintain understanding of NPC policies and ensure integrity and compliance; handle patient identifiable information per HIPAA and guidelines.
• Identify and report adverse events via established Novartis systems.

Buy and Bill Specific

• Assess access in the geography and develop a Plan of Action (POA); communicate POA to appropriate personnel.
• Establish preferred acquisition pathways; educate on buy-and-bill processes, workflows, and facility pull-through in complex accounts, including centralized/decentralized acquisition and alternative channels.
• Educate stakeholders on logistics related to ordering, payment, inventory, and returns/replacement.
• Analyze reimbursement issues and opportunities, serving as the designated reimbursement expert for offices and field teams.
• Engage with non-prescribers (pharmacy, system leadership, financial counselors, administrators, revenue cycle managers, etc.).

Minimum Requirements

• Bachelor’s Degree required; advanced degree preferred.
• 3–5 years in public/private third-party reimbursement or pharmaceutical industry in managed care, clinical support, or sales.
• Experience with specialty pharmacy products via Specialty Pharmacy networks or specialty distributors (buy and bill).
• Experience with coding, billing, and in-office support programs.
• Prior account management experience or experience with complex accounts (payer landscape, high patient volume, large systems).
• Specialty pharmacy experience (ability to teach an office the process from script to injection).
• Ability to build relationships within a practice to remove reimbursement barriers for patients.
• Knowledge of CMS policies and Medicare Parts B and D; knowledge of managed care, government, and federal payer sectors is a plus.
• Team-oriented with ability to collaborate across functions to reach goals.
• Ability to travel across a large multistate geography; at least 50% travel required.
• Must live within the assigned territory; driving is an essential function with a valid driver’s license.

Preferred Qualifications

• Ability to manage multiple products.
• Excellent presentation skills.
• Advanced knowledge of medical insurance terminology.
• Strong teamwork, project management, and independent work capabilities.
• Ability to manage expenses within budgets.
• Good driving record; ability to schedule travel as needed.
• Proficiency in PowerPoint, Excel, Word, CRM (Salesforce).
• Understanding of patient privacy laws including HIPAA and related state laws.
• Strong business acumen; ability to travel with a valid driver’s license.