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AD, Access & Reimbursement RLT - Los Angeles, CA - Remote

Novartis
Full-time
Remote
United States
$160,300 - $297,700 USD yearly
Market Access

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Role Summary

The Associate Director, Access & Reimbursement, RLT (Radioligand Therapy) is a remote/field-based role supporting access, reimbursement and patient support across assigned geographies. The role includes education to accounts, management of pull-through of access strategies, and collaboration with cross-functional teams to facilitate patient access and appropriate program implementation.

Responsibilities

  • Interact with large, complex accounts to support patient access, providing face-to-face education to providers and staff to integrate products into office processes and workflows.
  • Address customer questions regarding NPC policies on ordering, payment, inventorying, and product returns in offices.
  • Collaborate with executives, providers, administrators, billing and coding staff, claims departments, and revenue cycle managers to support patient access to products.
  • Analyze problems and provide solutions related to patient reimbursement; support reimbursement questions with third-party payers; identify trends and partner internally/externally to enhance patient access to medicines.
  • Support pull-through on local coverage decisions; communicate policy changes or issues affecting other departments.
  • Inform customers about NVS-sponsored patient support programs (e.g., Co-pay) to aid patient initiation and continuation of therapy.
  • Maintain expertise in regional/local access landscape and serve as reimbursement expert for aligned products when needed.
  • Interface with Patient Support Center and Access & Reimbursement Managers on patient case management, tracking, issue resolution, reimbursement support, and staff education.
  • Collaborate cross-functionally within NPC to address customer needs and barriers related to access and reimbursement.
  • Maintain understanding of NPC policies, handle patient data per HIPAA and internal guidelines, and report adverse events as required.

Buy and Bill Specific

  • Assess access situations and develop a Plan of Action (POA); communicate POA to relevant personnel.
  • Educate HCPs on acquisition pathways, buy-and-bill end-to-end processes, and facility pull-through in complex accounts (centralized/decentralized acquisition; alternative channels).
  • Educate stakeholders on logistics for ordering, payment, inventory, and product returns/replacements.
  • Analyze reimbursement issues and act as the designated reimbursement expert for offices and field teams.
  • Engage with non-prescribers (pharmacy, system leadership, financial counselors, administrators, revenue cycle managers) as appropriate.

Radioligand Therapies Specific

  • Partner with the NPC Patient Support team on supply capacity, site procurement eligibility, and communications on orders and logistics.
  • Understand RLT priorities, site readiness for procurement and billing to facilitate orders; identify gaps and coordinate with cross-functional partners to resolve.
  • Collaborate with customer engagement teams to facilitate procurement/logistics and provide patient-specific support (benefit verification, PA, appeals, copay programs, rebates).
  • Coordinate with Market Access to support site onboarding and purchase agreements/GPO forms as liaison for RLT Access Lead (RAL).
  • Support treatment site onboarding (RAM license, W9, PRD preferences).
  • Apply major accountabilities across therapy, diagnostic, and theragnostic treatment centers.

What Youโ€™ll Bring To The Role

Education: Bachelorโ€™s degree required; business and/or biological science preferred. Advanced degree preferred.

Essential Requirements

  • 5+ years in pharmaceuticals/biotech focused on Patient Services, Market Access, Sales, or account management; 2+ years in a patient services support role for a specialty product.
  • Experience with highly complex practices/health systems to establish access and acquisition pathways.
  • Strategic account management with proactive planning to address access hurdles.
  • Deep expertise in integrating manufacturer-sponsored patient support programs.
  • Experience with specialty products via Specialty Pharmacy networks.
  • Knowledge of reimbursement pathways (specialty pharmacy, buy-and-bill, retail).
  • Strong understanding of commercial payers, Medicare plans, and state Medicaid in the region.
  • Must live within the assigned territory.
  • Ability to travel at least 50% of the time, depending on geography/territory.
  • Driving is an essential function; valid and unrestricted driverโ€™s license required.
  • Accommodations available if reasonable without eliminating essential driving function.

Desirable Requirements

  • Experience presenting to C-level account executives.
  • Ability to work cross-functionally with Field Sales, Marketing, Market Access, Public Affairs, State & Government Affairs, Trade, Specialty Pharmacy Account Management, and third-party affiliates.
  • Expertise in therapeutic area dynamics and reimbursement/program needs.
  • Strong focus on customer service, collaboration, business acumen, communication, and presentation skills.
  • Field-based role requiring substantial use of a company-provided vehicle and good driving record.
  • Ability to manage field expenses and provide timely reports.

Education / Compensation Notes

Details regarding compensation and benefits are described in the posting and are not included here as part of the role content.

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