Position Summary:
The Access & Reimbursement Manager (ARM) is a subject matter expert for FILSPARI (Sparsentan), working remotely within an assigned geography to provide education and case-specific support to healthcare providers (HCPs) and the sales force. Must proactively manage multiple priorities and navigate insurance/access barriers.
Responsibilities:
- Serve as key contact for patient access and reimbursement in assigned geography.
- Lead FILSPARI onboarding support from Patient Start Form (PSF) submission through REMS enrollment to reimbursement.
- Educate physicians/practices on onboarding steps: PSF completion, REMS enrollment, prior authorization/appeals, and reimbursement medical policy requirements.
- Monitor cases through onboarding; provide escalated support for complex access/reimbursement issues.
- Assist with missing PSF/REMS information and coordinate with Hub/REMS partners.
- Resolve access issues (prior authorization, appeals, denials, letters of medical necessity, REMS) and prevent future hurdles.
- Partner with specialty pharmacy, sales, HCP offices, and REMS administrator to move patients through reimbursement.
- Provide sales updates: log calls/notes in standardized platform daily; lead weekly case status meetings; ride with/educate sales on reimbursement complexities.
- Identify reimbursement trends and develop quarterly business plans; educate internal/external stakeholders on payer changes.
- Ensure HIPAA compliance within program guidelines.
Education/Experience Requirements:
- Bachelorβs degree in related field (or equivalent education + experience).
- 5+ years in pharmaceutical/health industry working with hubs, payers, and HCPs.
- 3+ years reimbursement/access/case management experience.
- Specialty pharmaceutical, nephrology, rare disease, and REMS experience preferred.
Additional Skills/Experience:
- Experience with new-to-market access complexities; prior account management with complex payers (incl. government payer/VA) preferred.
- Relationship building with HCPs/office staff, sales, and Hub counterparts.
- Comprehensive understanding of private/commercial and government payer reimbursement (e.g., Medicare Part D, VA).
- Ability to educate on benefit verification, prior authorization, appeals, denials, letters of medical necessity, pre-determination.
- Basic computer skills (e.g., Excel, PowerPoint); ability to resolve issues virtually.
- Field-based: live in territory/immediate adjacency; travel up to 35%; face-to-face work and credentialing at onsite facilities in territory.
Application Instructions:
- Apply; Travere accepts applications on an ongoing basis until a candidate is selected.