Description The Access & Reimbursement Manager (ARM) will operate as the subject-matter expert on reimbursement, access, and coverage issues affecting the client's products. The ARM role is a remote/field-based role that proactively provides in person (or virtual if required) approved education to defined accounts within a given territory on matters related to reimbursement, access and coverage to facilitate appropriate patient access. The ARM will analyze reimbursement and access issues and act as the local access and reimbursement resource for other field force personnel and region management, as permitted by policy. Where appropriate, the ARM will coordinate with the hub concerning individual patient cases including patient access and coverage assistance, hub enrollment and overall coordination. The ARM will need to collaborate cross functionally with Field Sales, Marketing, Market Access, Public Affairs, State and Government Affairs, Trade and Specialty Pharmacy Accounts while abiding by all corporate and industry policy and procedures.
Access & Reimbursement Managers manage daily activities that support appropriate patient access to our client's products and work as a liaison to other patient support programs offered by our client. Activities include, but are not limited to:
- Analyze access/reimbursement issues
- Provide product access/reimbursement education to HCP offices
- Provide access/reimbursement education to field teams upon approved direction.
- Coordinate on access/reimbursement issues with third parties including hubs
- Provide education and support on Specialty Pharmacy issues for pharmacy benefit products
- Provide information to HCP on how the products are covered under the benefit design (Commercial, Medicare Part D, Medicaid)
- Answer questions about coverage, ICD-10 codes of product, including patient-specific access questions
- Educate and update HCPs on key private and public payer coverage and changes that impact product access for patients
- Support patient access to the product by providing subject matter expertise on payer coverage issues impacting product access in a manner that complies with policies, processes and standard operating procedures
- Educate HCP offices on the product hub program including, e.g., patient support offerings, financial assistance and hub educational resources
- Demonstrate knowledge of and communicate information about access resources and payer processes/policies
- Attend National and Regional Meetings
Along with demonstrated initiative, resourcefulness and a results-oriented mindset, the ideal candidate has:
- Bachelor's Degree or 4+ years professional sales, healthcare, scientific, marketing or military experience
- Minimum three years' experience in public or private third party reimbursement arena or pharmaceutical industry in managed care, patient services, or clinical support.
- Pulmonary Arterial Hypertension experience preferred. Cardiology, Pulmonology and/or orphan drug experience preferred.
- Proven experience with hubs, in-depth knowledge on issues related to billing, coding, appeals across provider types
- Experience with commercial payers, Medicare plans and state Medicaid in geographic region
- Exhibit competent understanding of hub and patient support activities
- Communicate clearly and effectively - written and verbal
- Local and national travel required for this position
- Ability to operate as a "team player" in collaborating with multiple sales representatives, sales leadership, and internal colleagues appropriately to reach common goals
- Ability to travel and possess a valid driver's license to drive to assigned healthcare accounts, unless otherwise specified
- Must live within territory or within territory boundaries.
The annual base salary for this position ranges from $145,000-$155,000. The base salary range represents the anticipated low and high of the Syneos Health range for this position. Actual salary will vary based on various factors such as the candidate's qualifications, skills, competencies, and proficiency for the role. In addition, some positions may include a company car or car allowance and eligibility to earn commissions/bonus based on company and / or individual performance.
At Syneos Health, we believe in providing an environment and culture in which Our People can thrive, develop and advance. We reward and recognize our people by providing valuable benefits and a quality-of-life balance. The benefits for this position will include a competitive compensation package, Health benefits to include Medical, Dental and Vision, Company match 401k, flexible paid time off (PTO) and sick time. Because certain states and municipalities have regulated paid sick time requirements, eligibility for paid sick time may vary depending on where you work. Syneos Health complies with all applicable federal, state, and municipal paid sick time requirements.
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