AD, Access & Reimbursement (ADAR) NPS CV -Remote- Las Vegas, NV

Role Summary

The Associate Director, Access & Reimbursement (ADAR) for NPS Cardiovascular is a remote, field-based role covering Las Vegas, NV and surrounding territories (Las Vegas, Salt Lake City, Flagstaff). The role requires residence within the territory or within a 60-mile daily commuting distance. The ADAR provides in-person or virtual education on access and reimbursement topics to defined accounts to support product strategy, with focus on complex accounts and integration of manufacturer support programs into account workflows. They lead patient access initiatives in business-to-business discussions with account teams and collaborate cross-functionally within NPC to address payer coverage, billing, claims, reimbursement, and related access barriers. Travel may be required up to 50% depending on geography.

Responsibilities

• Interact with large, complex accounts to support patient access within their aligned therapeutic area product(s), proactively provide face-to-face education on programs to providers and staff to support integration of those products into office processes and workflows.
• Address customer questions for issues related to NPC policies on therapeutic area products ordering, payment, inventorying, and product returns & replacement in offices.
• Work with key members of therapeutic area offices (e.g., executives, 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 patient reimbursement and provide support on reimbursement issues with third party payers at the provider-level. Analyze account reimbursement issues (as needed). Identifies trends at a local, regional and national level and partner with purpose internally and externally to support patient access to Novartis medicines.
• Supports pull through on local coverage decisions to enable meaningful patient access within the system. Proactively communicate policy changes or issues that could potentially affect other departments.
• Accountable for informing customers on NVS-sponsored patient support programs to help enable patients starting and staying on therapy (i.e., Co-pay).
• Maintain expertise in regional and local access landscape, anticipating changes in the healthcare landscape, and act as their aligned therapeutic area product(s) reimbursement expert (as needed).
• Interface with Patient Support Center (hub) and Access & Reimbursement Managers on important matters related to patient case management, including tracking cases, issue resolution, reimbursement support, and appropriate office staff education.
• Collaborate with aligned cross-functional associates within NPC 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 HIPAA and other privacy laws and regulations and internal Company compliance guidelines).
• Responsible for identifying and reporting adverse events via the established Novartis systems as per applicable processes.

Qualifications

• Required: 5+ years of experience in pharmaceuticals / biotech industry focused in Patient Services, Market Access, Sales, and/or account management, with 2 of those years in a Patient Services practice support role for a specialty product(s).
• Required: Experience working with highly complex practices and/or health systems to establish access and acquisition pathways.
• Required: Strategic account management experience using a proactive approach to anticipate access hurdles impacting accounts and patient access.
• Required: Deep expertise and experience integrating manufacturer-sponsored patient support programs.
• Required: Experience with specialty products acquired through Specialty Pharmacy networks.
• Required: Knowledge of reimbursement pathways (specialty pharmacy, buy-and-bill, retail).
• Required: Possess a strong understanding of Commercial payers, Medicare plans and state Medicaid in geographic region.
• Required: Must live within assigned territory.
• Required: Ability to travel and cover geography, at least 50% travel required, based on geography and territory / targeting makeup.
• Required: Driving is an essential function of this role, meaning it is fundamental to the purpose of this job and cannot be eliminated. Because driving is an essential function of the role, you must have a fully valid and unrestricted driver’s license to be qualified for this role.

• Preferred: Experience leading and delivering presentations to C-level account executives.
• Preferred: Strong ability to work cross functionally with such functions as Field Sales, Marketing, Market Access, Public Affairs, State & Government Affairs, Trade, Specialty Pharmacy Account Management and applicable third-party affiliates.
• Preferred: Expertise in therapeutic area practice dynamics and common reimbursement and product program support-related needs.
• Preferred: Strong capabilities in the areas of customer focus, collaboration, business acumen, communication, and presentation skills.
• Preferred: This position requires significant use of a company provided vehicle and maintaining good driving record.
• Preferred: This is a field-based customer engaging position.
• Preferred: Control business expenses related to field activities (i.e., travel, customer meetings) and provide timely expense reports to manager.

Education

• Bachelor’s Degree required. Business and/or biological science education preferred. Advanced degree preferred.

Additional Requirements

• Travel: Ability to travel and cover geography, at least 50% travel required, based on geography and territory makeup.
• Driving: Driving is an essential function of this role; must have a fully valid and unrestricted driver’s license to be qualified.