Field Access Lead - Detroit, MI

Role Summary

Location: Detroit, MI. The Field Access Lead (FAL) executes Pfizer’s strategic vision for patient access to approved therapies while maintaining compliance. This field-based role reports to the Field Access Director and collaborates with commercial and US Market Access colleagues to proactively and reactively engage territory accounts, ensuring patient access and resolving challenges. The FAL serves as the local expert on patient access for accounts with workflow complexities (multi-provider specialty groups, IDNs, hospital systems, and integrated pharmacy networks) and provides payer policy education at local, regional, and national levels. Candidates must have strong knowledge of Commercial and Medicare insurance structures and experience communicating payer policy and utilization management criteria to internal and external stakeholders.

Responsibilities

• Patient Access
  • The FAL is an expert in access and reimbursement for Pfizer approved therapies and is responsible for identifying pathways to higher rates of patient access and addressing challenges within a defined geographic area.
  • Plays a pivotal role navigating the complexities of multi-specialty practices, health systems and IDNs to help establish relationships and influence successful access to Pfizer’s products with key account personnel and those specifically responsible for patient access, coding, billing & reimbursement.
  • Anticipates changes in the healthcare landscape and proactively coordinates comprehensive educational opportunities to enhance customer knowledge related to:
    • Commercial and government payer coverage policy for Pfizer approved therapies
    • Prior authorization, utilization management criteria and medical exception processes
    • Payer specific documentation requirements and appeal processes
    • New to market pathways and requirements for patient access
    • HUB related information and Pfizer patient affordability programs
    • Patient Case Management to expediate access to Pfizer approved therapies
• Account Management
  • Manage a set of proactive accounts, along with reactive referral escalations, to analyze and understand the local insurance environment, and meet patient access business objectives.
  • Collaborates with an account management focus, working both independently and in close partnership with internal stakeholders to develop and achieve strategic plans of actionable support for customers in multiple systems of care.
  • Identify, connect, and educate various stakeholders to develop a plan of action with the goal of increasing patient access to Pfizer products.
• Business & People Leadership
  • Drive and align with appropriate internal stakeholders/ decision makers based on account plans and goals to ensure compliant, effective, and successful results with shared customer relationships.
  • Will ensure appropriate patient access by influencing, leading, and collaborating with other US Market Access functions, Area Business Managers and Sales representatives from Migraine, CV, IM, and WH, the HUB partner, as well as the specialized KAD team, HSSS team, and Medical Team.
  • Are responsible for developing and executing integrated account team (IAT) business plans that balance internal dynamics & data streams while prioritizing customer needs for support. Recognizes when and how to involve colleagues from other functional areas to assist in addressing all downstream questions within aligned accounts.
  • Provides, as deemed appropriate, interpretive information and local market insights to relevant internal Pfizer stakeholders as to the impact of potential access related challenges.
  • Responsible for analyzing the local market environment, and key account priorities, to effectively develop a plan of action that is mutually beneficial to patients, customers, and Pfizer.
  • Share and help scale proven practices of Market Access trends related to evolving payer policies across the Region and Nation.
  • Lead, drive, monitor, and assess internal and external education, access account strategy development, and IAT access initiatives.

Qualifications

• Required: Minimum 7+ years pharmaceutical industry experience typically within the fields of pharmaceutical sales and/or coding, access and reimbursement.
• Preferred: Reimbursement and Access experience is highly preferred.
• Required: Strong understanding of Specialty Drug Reimbursement, Government Payment Systems, Provider/Carrier Networks, Co-Pay Assistance Programs, and knowledge of the policy dynamics that exist across the various Pfizer Business Units/Brands.
• Required: B.S. or B.A. degree is required.
• Required: Experience demonstrating exceptional communication and presentation skills, strategic planning, problem-solving skills, and successful plan implementation. This individual must also have demonstrated leadership and success at working across internal boundaries and be able to collaborate with multiple relevant stakeholders to coordinate various unique objectives.
• Required: Demonstrated ability to work in a highly regulated environment and adhere to strict company compliance guidelines and procedures. Proven track record of collaborating broadly with a diverse range of customers, clients, and stakeholders. Training in and experience in responsible business communication both written and spoken.
• Required: Valid US driver’s license and driving record in compliance with company standards. Any DUI/DWI or other impaired driving citation within the past 7 years will disqualify you from being hired.
• Required: Thorough understanding of the technical payer policy processes, systems and requirements for coverage and reimbursement policies.
• Required: Demonstrated understanding of the rules and regulations associated with the provision of reimbursement support services.
• Required: Strong understanding and ability to communicate the technical elements of payer prescription approval processes.

Preferred Qualifications

• Preferred: Additional certification in coding and reimbursement is preferred but not required
• Preferred: Coding and billing knowledge or certification a plus but not required
• Preferred: Candidate demonstrates a breadth of diverse leadership experiences and capabilities including: the ability to influence and collaborate with peers, develop and coach others, oversee and guide the work of other colleagues to achieve meaningful outcomes and create business impact.