Pharming Group · 1 day ago
Associate Director, Reimbursement and Access
United States
Full-time
Hybrid
Lead/Staff, Director/Executive
$170K/yr - $190K/yr
5+ years expPharming Healthcare Inc. is a global biopharmaceutical company dedicated to transforming the lives of patients with rare diseases. The Associate Director, Reimbursement and Access will support healthcare providers in gaining access to the company's product, Ruconest, by managing reimbursement and access needs across the assigned territories.
Biotechnology
Responsibilities
Handling all coverage, reimbursement and access needs across their territories/regions and work directly with their respective Sales Representatives, Hub Case Managers, National Account Directors (NADs) and customers (HCP facing)
Work directly with Hub vendor to understand payer coverage issues and assist with prior-authorization (PA) denials and appeals by working with physicians and staff, helping prepare HCPs for Peer-to-Peer needs
Proactively track patients from submission of enrollment form through to shipment in order to identify potential issues and work to enable timely resolutions
Provide training and education to HCPs on payor specific coverage policies and authorization documentation requirements, appeals processes and patient financial assistance support programs
Develop and maintain positive working relationships with both internal team members (e.g., Sales Reps, NADs, Case Managers and Clinical Educators) and external stakeholders (e.g., physicians, office staff, Specialty Pharmacy partners)
Work with HCPs and specialty pharmacy to overcome quantity limits or high dollar overrides
Escalate and engage the NAD when payer coverage or payment issues are identified, providing detailed specifics on issues, steps attempted to resolve, and identify key items that need addressing with the payer
Communicate issues and status with internal stakeholders and leaders (NADs, RBDs, VP of Sales)
Communicate opportunities and challenges related to patient access issues to internal stakeholders
Work collaboratively to improve access and reimbursement tools and processes
Performs other duties as assigned
Qualification
Required
Bachelor's Degree from an accredited university
3+ years' experience as a Field Reimbursement Manager
5+ years cross-functional experience in the pharmaceutical/biotech industry
2+ Years' experience with prior authorization and multi-level appeals
Preferred
3+ years' experience as a Field Reimbursement Manager for a biologic / buy & bill (physician-administered, IM/SC injectable, IV injection, infusion) drug experience highly preferred
Immunology background and rare or ultra-rare disease industry experience highly preferred
Excellent working knowledge of reimbursement and access challenges in the current healthcare environment
Ability to communicate payer coverage criteria and prior authorization/appeals processes to HCPs and staff including prepping HCP's for Peer-to-Peer discussions
Experience working with Specialty Pharmacies to resolve access issues
Experience working with a Hub to obtain necessary payer information and facilitating next steps
Experience working with multiple internal stakeholders. (sales, managed markets, patient advocacy, government affairs, etc.)
Demonstrated ability to apply reimbursement knowledge to address/resolve patient access barriers
Possess interpersonal skills including managing and resolving conflict and building strong working relationships
Proven track record for consistently meeting or exceeding goals and objectives
Proficient in working in a cross functional environment while handling multiple tasks
Travel - Include 50% travel time required for the position where travel occurs locally or internationally. Travel to HCP offices, with or without Sales Reps, to work with appropriate level stakeholders to respond to coverage or payment issues (i.e., 2 to 3 days in the field)
Commitment and alignment to Pharming's mission, core values and behaviors
Benefits
Flexible hybrid work schedule to promote a healthy work-life balance OR A fully remote work schedule
Competitive compensation package including annual target bonus
Long-term incentive program
401(k) plan with company match
Paid Time Off (PTO)
13 Company Holidays per year
Excellent benefit plans including medical, dental, and vision
Flexible spending accounts
Company-provided life insurance, short-term disability, and long-term disability plans
Optional accident, hospital indemnity, critical illness, and pet insurance plans
Tuition reimbursement program
Health and wellness program
Choice of company provided mobile phone or cell phone stipend
Company
Pharming Group
Pharming Group is a global biopharmaceutical company dedicated to transforming the lives of patients with rare, debilitating, and life-threatening diseases.
201-500 employees
Funding
Current Stage
Growth StageLeadership Team
Anurag Relan
Chief Medical Officer
Stephen Toor
Chief Commercial Officer
Company data provided by crunchbase