Field Reimbursement Manager - Houston, TX
Ardelyx, Inc.
6 months ago
On-site
Houston, TX
Market Access
Responsibilities:
- Establish and maintain collaborative relationships with Patient Services Program Partners, Field Sales, and Healthcare Providers to support patient access.
- Educate HCPs on prior authorization, appeals, and/or denials to support the patient journey.
- Review patient-specific information when sites request assistance resolving coverage issues.
- Partner with internal/external stakeholders to identify, anticipate, and address access barriers; implement solutions/updates.
- Use HUB and specialty pharmacy partners to remove patient access barriers.
- Monitor patient start trends in assigned geographies/plans and proactively address challenges with Field Sales and Patient Services.
- Maintain knowledge of payor/prescriber market dynamics and HUB/specialty distribution channels.
- Serve as subject matter expert on access and affordability solutions across payer types (e.g., Medicare, Medicaid Managed Care, Commercial).
- Adapt to the changing healthcare ecosystem to customize resourcing and messaging.
Qualifications & Skills:
- B.A./B.S. with 6–9 years in field reimbursement, patient services, market access, or related pharma/biotech experience (or equivalent).
- 3–5 years as a field reimbursement manager in field reimbursement/access services and/or healthcare operations (public or private).
- Strong knowledge of medication access channels (preferred).
- Expert understanding of specialty pharmacy and insurance/benefits (Medicare Part D, commercial, Medicaid): eligibility, benefit verification, prior authorization, coverage, appeals, financial assistance, co-pay support, and free product programs.
- Knowledge of HCP office processes for patient/prescription flow and clinic operations; GI product/provider experience preferred.
- Excellent relationship, interpersonal, and communication skills; ability to influence cross-functionally.
- Ability to evaluate data, identify trends/barriers, and translate into actionable steps.
Benefits (as listed): 401(k) with employer match, paid parental leave (12 weeks), living organ/bone marrow leave (up to 12 weeks), health plans, life insurance/disability, equity incentive plans, flexible time off, Winter Holiday shutdown, and at least 11 paid holidays.
- Establish and maintain collaborative relationships with Patient Services Program Partners, Field Sales, and Healthcare Providers to support patient access.
- Educate HCPs on prior authorization, appeals, and/or denials to support the patient journey.
- Review patient-specific information when sites request assistance resolving coverage issues.
- Partner with internal/external stakeholders to identify, anticipate, and address access barriers; implement solutions/updates.
- Use HUB and specialty pharmacy partners to remove patient access barriers.
- Monitor patient start trends in assigned geographies/plans and proactively address challenges with Field Sales and Patient Services.
- Maintain knowledge of payor/prescriber market dynamics and HUB/specialty distribution channels.
- Serve as subject matter expert on access and affordability solutions across payer types (e.g., Medicare, Medicaid Managed Care, Commercial).
- Adapt to the changing healthcare ecosystem to customize resourcing and messaging.
Qualifications & Skills:
- B.A./B.S. with 6–9 years in field reimbursement, patient services, market access, or related pharma/biotech experience (or equivalent).
- 3–5 years as a field reimbursement manager in field reimbursement/access services and/or healthcare operations (public or private).
- Strong knowledge of medication access channels (preferred).
- Expert understanding of specialty pharmacy and insurance/benefits (Medicare Part D, commercial, Medicaid): eligibility, benefit verification, prior authorization, coverage, appeals, financial assistance, co-pay support, and free product programs.
- Knowledge of HCP office processes for patient/prescription flow and clinic operations; GI product/provider experience preferred.
- Excellent relationship, interpersonal, and communication skills; ability to influence cross-functionally.
- Ability to evaluate data, identify trends/barriers, and translate into actionable steps.
Benefits (as listed): 401(k) with employer match, paid parental leave (12 weeks), living organ/bone marrow leave (up to 12 weeks), health plans, life insurance/disability, equity incentive plans, flexible time off, Winter Holiday shutdown, and at least 11 paid holidays.