Area Reimbursement Lead - IN, KY, MI, OH, WV Territory - Remote

Role Summary

The Area Reimbursement Leader (ARL) – Cardiovascular is a field-based leadership role responsible for guiding a team of Access Reimbursement Managers (ARMs) across Indiana, Kentucky, Michigan, Ohio, and West Virginia, while also providing hands-on support for complex access issues. The ARL coaches ARMs, partners with the Associate Director, Access & Reimbursement, and reports to the Regional Director to ensure comprehensive access support for large systems of care and field initiatives. The role drives strategic execution, minimizes reimbursement barriers for patients and providers, ensures compliance and operational excellence, and communicates issues and trends to cross-functional stakeholders. This is a remote, field-based role with travel within the territory required (up to 60 miles from the border). The associate must reside within the territory or a reasonable commuting distance.

Responsibilities

• Lead, develop, and coach a team of ARMs to achieve and exceed business goals, objectives, and metrics.
• Develop, communicate and cascade Cardiovascular ARM strategies, plans, objectives and metrics and align these with the overall ARM and community-based strategies as appropriate.
• Guide, coach and mentor field team (including helping to solve complex reimbursement issues) as well as conduct regular field rides with ARMs to gain first-hand knowledge of customer access concerns and questions.
• Create and implement area-level strategic plans incorporating data insights, resource utilization, and actionable goals to enhance patient access.
• Act as the key conduit between ARM teams and internal stakeholders, ensuring the timely escalation of access and reimbursement challenges.
• Manage performance evaluations, providing actionable feedback through field contact reports, and continuous feedback throughout the year.
• Collaborate with the RD to ensure alignment of ARM team objectives with area and regional strategies.
• National and Regional Leadership Support: lead projects and initiatives at area, regional, and national levels to support organizational priorities.
• Manage travel, budget, and expenses in alignment with organizational policies and expectations.
• Maintain a deep understanding of NPC policies and requirements and perform all responsibilities with integrity and in a manner consistent with company guidance and policies, relevant state and federal laws and regulations, 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). This comes with the added accountability of ensuring your team is also adhering to NPC guidance and policies and relevant state and federal laws and regulations.
• Responsible for identifying and reporting adverse events via the established Novartis systems as per applicable processes.
• Serve as an access and reimbursement expert within assigned accounts and customers in addressing complex scenarios, including but not limited to: Navigating payer policies, billing, and coding challenges; developing and implementing solutions for access hurdles in centralized and decentralized systems of care; facilitating education and integration of manufacturer support programs into office workflows.
• Support ARMs by managing relationships with key decision-makers at accounts, including alternate sites of care.
• Collaborate with ARMs to provide tailored solutions for local coverage issues, payer policy changes, and other access barriers.
• Provide hands-on support for accounts requiring additional resources or expertise due to workload constraints or complexity.
• Actively contribute to seamless integration of access and reimbursement insights into broader field efforts, leveraging expertise from ARMs and ADARs.
• Facilitate knowledge-sharing and collaboration between ARMs and ADARs to optimize resource utilization and improve access outcomes.
• Build relationships with key accounts and stakeholders to establish trust, anticipate needs, and drive resolution of complex reimbursement issues.
• Meet and exceed designated KPIs related to NPS Cardiovascular TA objectives, talent development, customer satisfaction, and program awareness.

Qualifications

• Required: Bachelor’s Degree; Advanced degree preferred.
• Required: 2+ years of first-line leadership experience; for internal associates, participation in leadership programs and 5+ years of experience in Access & Reimbursement, Market Access, and/or Patient Services; 5+ years of Access & Reimbursement experience (Buy-and-Bill strongly preferred).
• Required: Demonstrated excellent working knowledge of reimbursement and practice management environment; strong understanding of Commercial payers, Medicare plans and state Medicaid in the geographic region; experience in patient assistance support, reimbursement support and other access programs.
• Required: Travel as needed; candidate must live within assigned geographic area; driving is an essential function with a fully valid/unrestricted driver’s license.
• Required: Ability to comply with company HIPAA/privacy guidelines and related legal requirements.
• Preferred: Excellent communication and ability to coordinate/manage large projects/initiatives.
• Preferred: Strong financial planning, analysis, and management skills; has built territory and account-specific business plans; strong teamwork and partnering skills; organizational and time management skills; resource optimization; influential presentation skills; customer orientation; capabilities in decision making, teamwork, business acumen, change management, and strategic agility.