Field Reimbursement Manager - Rheumatology

Role Summary

Field Reimbursement Manager, Rheumatology is the field subject matter expert for patient support, access, reimbursement, prior authorization, appeal, financial assistance, and related issues within the Rheumatology Business Unit. The FRM works with internal stakeholders and external partners to deliver a strong customer experience, develop and execute reimbursement strategies, and support patient pull-through efforts for Kevzara in a regionally aligned, field-based role.

Responsibilities

• Act as field point of contact for Rheumatology Patient Support Services and collaborate cross-functionally to lead Kevzara pull-through efforts while assisting sales partners as appropriate
• Function as a conduit to Specialty Pharmacy for escalations related to Kevzara to ensure continuity of patient care regarding medication access and adherence
• Be a subject matter expert on Kevzara Connect, Kevzarahcp.com, and patient support programs, including access issue resolution, financial assistance, and alternative funding options
• Conduct HIPAA-compliant HCP office or SP site visits to facilitate pull-through and resolve escalated issues as needed
• Educate field personnel on prior authorization and appeals processes, reimbursement support, free drug programs, and financial assistance programs
• Maintain knowledge of local and national payer landscapes, including Specialty Pharmacy and Utilization Management criteria for Kevzara
• Establish positive working relationships with internal and external customers to foster a culture of respect and customer focus
• Work to reduce cycle time and increase conversion rates for patients prescribed Kevzara
• Identify gaps in operational processes and collaborate with Sanofi to modify processes
• Provide PRB-approved information related to product coverage, including payer requirements for claims processing, prior authorizations, and appeals, plus general disease-state information
• Coordinate with field sales on prioritization of accounts to ensure targeted, timely lists of key accounts and maintain ongoing communication regarding account follow-up

Qualifications

• BA/BS Degree required
• Minimum 5+ years in the pharmaceutical/healthcare industry or relevant experience
• Experience in specialty biologics, pharmacy benefit reimbursement/access, specialty pharmacy, and/or Market Access a plus
• Ability to travel to meetings/trainings/programs as necessary; additional travel within geography
• Energetic, driven to succeed; strong interpersonal skills; ability to resolve conflicts
• Adaptable to change in a high-energy, fast-paced environment
• Strong strategic thinking, analytical, and communication skills
• Compliance with all applicable policies, regulatory and legal requirements
• Valid driver's license

Travel Requirements

• Approximately 50% travel depending on geography
• Ability to travel to meetings/trainings/programs when necessary
• Fleet safety training and maintaining an acceptable driving record required

Education

• Not specified beyond BA/BS degree in Basic Qualifications