Position Summary:
Access & Reimbursement Manager (ARM) for FILSPARI (Sparsentan), remote within assigned geography. Provides education and case-specific support to HCPs and sales force; expert in navigating insurance and access barriers. Preference: North New Jersey; other territory locations considered.
Responsibilities:
- Serve as key contact for patient access and reimbursement in assigned geography.
- Master FILSPARI onboarding from PSF submission through REMS enrollment to reimbursement; walk offices through onboarding and re-education.
- Educate physicians on PSF completion, REMS enrollment, prior authorization/appeals approvals, and medical policy steps for reimbursement.
- Monitor cases through onboarding; provide escalated support for complex issues.
- Help resolve missing PSF/REMS information and access issues (prior authorization, appeals, denials, letters of medical necessity, REMS) and educate to prevent repeat hurdles.
- Partner with reimbursement stakeholders (Hub, specialty pharmacy, sales, REMS administrator) to move patients through reimbursement.
- Lead sales communication: update statuses, ride/educate sales, log calls daily, lead weekly case status meetings; coordinate with stakeholders; ensure HIPAA compliance.
- Identify reimbursement trends locally; create quarterly business plan; educate internal/external stakeholders on payer changes.
Qualifications & Skills:
- Bachelorβs degree (or equivalent education + experience).
- 5+ years pharmaceutical/health industry experience with Hubs, payers, and HCPs; 3+ years reimbursement/access/case management.
- Preferred: specialty pharmaceutical, nephrology, rare disease, REMS experience.
- Demonstrated ability to manage new-to-market access complexities; complex account/payer experience (incl. government/VA).
- Strong knowledge of private/commercial and government reimbursement (e.g., Medicare Part D, VA); experience educating on benefit verification, PA, appeals, denials, letters of medical necessity, pre-determination.
- Computer skills (basic Excel/PowerPoint); strong relationship building, communication, organization, multitasking.
- Field-based: live in territory or immediate adjacency; travel up to 35%.