Access Reimbursement Manager- Florida North

Role Summary

We are seeking dedicated and results-driven Access and Reimbursement Manager (ARMs) to join our team. In this role, you will serve as the primary field-based resource to support practices in ensuring optimal patient access to a large pharmacy benefit specialty product. You will collaborate closely with healthcare providers and internal teams to address access barriers, deliver patient-centric solutions, and educate stakeholders on reimbursement processes.

Responsibilities

• Patient Access Support:
  • Work directly with HCP offices to provide expertise on access and reimbursement challenges, including benefits investigation, prior authorizations, appeals, and financial assistance.
  • Partner with healthcare providers to ensure patients have timely access to prescribed therapy by addressing access issues proactively.
• Education and Training:
  • Educate healthcare providers and their staff on payer-specific policies, coverage criteria, and reimbursement processes for the specialty product.
  • Conduct in-service programs and provide resources to help practices navigate access challenges effectively.
• Collaboration with Internal Teams:
  • Act as a liaison between the field team and internal stakeholders, providing insights on regional access trends and challenges.
  • Collaborate with trade, market access, sales, patient support services, and analytics teams to ensure alignment and support for practices.
• Problem Solving and Escalation:
  • Identify and resolve access barriers through collaboration with payers, specialty pharmacies (SPs), and other key stakeholders.
  • Escalate unresolved issues to appropriate teams, ensuring timely resolution and communication back to providers.
• Data-Driven Execution:
  • Leverage data and analytics tools to identify access trends, prioritize efforts, and report progress to leadership.
  • Maintain accurate records of activities and interactions with practices to ensure compliance and track outcomes.

Qualifications

• Bachelor’s degree required; advanced degree or certification in healthcare-related fields is a plus.
• Minimum of 5 years of experience in access and reimbursement, patient support services, or pharmaceutical field roles.
• Knowledge of pharmacy benefit structures, reimbursement processes, and specialty pharmacy networks.
• Experience in Hepatology, Gastroenterology is preferred
• Strong interpersonal and communication skills, with the ability to build relationships and provide exceptional customer service.
• Proven ability to work independently, prioritize tasks, and adapt to a fast-paced environment.
• 50-60% Travel required within the assigned territory.

Skills

• Expertise in access and reimbursement, including payer policies and processes.
• Strong presentation and training skills, with the ability to explain complex concepts in a clear and concise manner.
• Problem-solving mindset with a focus on delivering practical solutions.
• Ability to collaborate effectively with cross-functional teams and external stakeholders.