Associate Director, Field Reimbursement

Role Summary

The Senior Manager/Associate Director, Field Reimbursement will serve as a subject-matter expert in reimbursement, payer access, and coverage policy. The role serves as a strategic liaison between HCPs, payers, internal stakeholders, and external partners to ensure seamless patient access to Liquidia’s products.

Responsibilities

• Improve referral to ship rates and turnaround times (TAT) by identifying and implementing changes that improve program performance
• Improve adherence and persistency rates by identifying and implementing changes that improve program performance
• Collaborate with sales/marketing teams, serving as the reimbursement expert
• Act with a sense of urgency to address critical issues with referral pull through (such as missing referral information, unresponsive, authorization delays, etc.)
• Establish relationships with key accounts through in-person and virtual meetings
• Educate HCPs on the prescription enrollment journey, Liquidia Access Programs, insurance coverage landscape, prior authorization guidelines, clinical criteria requirements, and insights into the medical necessity and appeals process
• Triage between urgent and non-urgent workflows
• Ensure timely follow-up with accounts on all open items
• Assist with implementing training programs for sales and marketing to ensure a firm grasp of Liquidia Access Programs, insurance coverage landscape, specialty pharmacy process flows, coverage criteria/reimbursement for Liquidia products
• Monitor and analyze data to monitor product coverage and referral, pull through issues, and referral trends
• Escalate issues impacting product access and program performance
• Remain current on insurance coverage, reimbursement, and clinical policies to provide timely and relevant information to accounts
• Leverage company communication portals to ensure timely referral pull through updates with multiple stakeholders
• Analyze and monitor pending referral cases with relevant stakeholders
• Monitor and diagnose drivers for adherence and persistence trends
• Collaborate with internal stakeholders on Market Access needs
• Maintain compliance with all company policies and procedures

Qualifications

• Required: Bachelor’s degree
• Required: Knowledge of reimbursement principles including pharmacy benefit design, prior authorization, and appeals processes
• Required: 5+ years of field reimbursement or sales in the rare disease space, patient access, prior authorizations, or specialty pharmacy or other relevant experience
• Required: Experience working with Specialty pharmacies and/or HUBs
• Preferred: Experience in pulmonary hypertension disease state
• Preferred: PACS (Prior Authorization Certification Specialist)
• Preferred: Ability to navigate complex business circumstances
• Preferred: Ability to collaborate cross-functionally with internal/external customers