Reimbursement Manager

Confidential Company  •  IA and 6 other locations

5 - 7 years experience  •  Biotech/Pharma

Salary depends on experience
Posted on 10/12/17
Confidential Company
5 - 7 years experience
Salary depends on experience
Posted on 10/12/17

Field Manager - Health Policy and Reimbursement will execute local market plans to support field based priorities and manage and triage local health policy, quality, reimbursement, billing / coding, and patient access issues. Field Manager - Health Policy and Reimbursement will collaborate with his / her field partners to alleviate reimbursement issues impacting physician offices and the ability of patients to access the Sun portfolio of products. The Field manager will interact with access services hub, managed markets team supporting payor access and local field sales teams. The person in this role with have expertise in reimbursement issues encompassing billing & reimbursement guidelines by payor and site of care, understanding of coding guidelines (CPT/J-Code/ICD-10), DRGs, statutory or commercial pricing structures, and quality programs related to value based care and clinical care pathways.

Responsibilities include:
•    Incorporate knowledge of dynamic and complex marketplace and business trends to deliver maximum access to the portfolio of Sun products.
•    Develop and maintain a relevant network of decision makers like Carrier Advisory Committee Members, State Society Officers, and key stakeholders responsible for health policy, reimbursement, and  quality.
•    Effectively communicate key legislative and health policy updates to the field sales organization and key external stakeholders 
•    Provide support to local market patient foundations and physician societies for activities related to access. 
•    Possess expertise in Medicare policies including building relationships with Medicare Administrative Contractors. 
•    Anticipate changing payer landscape by demonstrating a deep understanding and knowledge of public payer emerging trends that can impact access for Sun’s branded products and pipeline. 
•    Ensure processes are in place to drive clear communication with sales teams to ensure clarity of reimbursement issues and opportunities and support pull-through efforts.  
•    Listen and respond appropriately to customer needs and questions.
•    Effectively and persuasively communicate with customers using effective selling, listening and negotiation skills, proper terminology and approved messaging.
•    Maintain thorough knowledge of Sun products.
•    Regularly and timely communicate with manager, as well as members of various support teams, as required.
•    Create and maintain a positive impression with customers.
•    Prepare reports for management as needed.
•    Participate in teleconference and live National, regional and district meetings and training sessions and represent Sun at national and/or local conventions when requested.
•    Operate consistent with Healthcare Compliance guidelines.

Job Qualifications
Education:    A minimum of a Bachelor’s Degree is required.
Experience:    5 or more years of healthcare industry experiencerequired. Candidates should have an advanced understanding of the federal regulatory processes and healthcare policy development especially the Medicare/Medicaid program. A minimum of 3 years’ experience in the healthcare industry including but not limited to, insurance verification and / or claim adjudication, physician office or outpatient billing, pharmacy and or pharmaceutical manufacturers is required. This position requires up to 50% travel.

Additional Requirements
•    Proven teamwork and collaboration skills with a demonstrated track record of working in highly matrixed and cross-functional work teams 
•    Applies appropriate interpersonal styles and communications methods to influence and build effective relationships with business partners.
•    Able to effectively manage competing priorities with strong sense of urgency. 
•    Able to act as an articulate advocate for the market access team 
•    Provides consistent communications (both positive and negative information delivery) and is proactive and timely in the conveyance of this information. 
•    Uses appropriate methods and interpersonal styles to develop, motivate, and guide a team toward successful outcomes and attainment of business objectives. 
•    Strong written and verbal communication skills.
•    Strong presentation skills.
•    Highly developed analytical skills with demonstrated ability to conceptualize issues and synthesize data to provide strategic direction
•    Experience in Sun Pharma’s therapeutic areas.
•    Acts as a role model for others in line with Sun’s values

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