Field Reimbursement Manager - West

This position is with Recordati Rare Diseases, Inc. (RRD), North America, an affiliate of Recordati.

Recordati Rare Diseases, Inc. (RRD) develops high-impact therapies for rare diseases, focusing on providing treatments to underserved communities in the U.S. Our mission is to mitigate the impact of rare diseases through increased awareness, better diagnoses, and improved treatment access in endocrinology, metabolic, hematology and oncology franchises. RRD is dedicated to fostering a dynamic work environment that promotes professional growth and a significant impact on patients' lives.

Reporting Structure

Reports To:    Sr. Director, US Patient Services and Payer Access
Direct Reports:    None
Areas Managed:    Field Reimbursement
 

Overview

The Field Reimbursement Manager (FRM) will be responsible for managing accounts in a specified region focusing on but not limited to Endocrinology. The FRM is responsible for providing access and reimbursement education to healthcare providers (HCPs), office personnel including medical policies, prior authorization requirements, coding and billing, product access via buy-bill or specialty pharmacy with the goal of minimizing barriers to therapy. The FRM also supports by providing general education and case-specific guidance in response to prior authorization denials. This role involves investing some time on-site with HCPs, assessing their access and reimbursement needs education needs and facilitating collaboration with various stakeholders.

Key Responsibilities

•    Partnering with cross-functional parties on overall account and territory strategy to maximize internal/external customer knowledge on payor policy and processes
•    Collaborate with Specialty Pharmacy to follow up with accounts that have outstanding prior authorization or appeals submissions
•    Being a subject matter expert on reimbursement and regional-specific access landscape. This includes payor policies, prior authorization requirements, denials, appeals, peer to peer and other education required to navigate access for coverage of company therapies
•    Collaborating with cross-functional parties on individual case management needs related to HCP education on reimbursement issues
•    Leveraging all available resources including internal data to develop and execute account plans/call purpose
•    Complying with all laws, regulations and policies that govern the conduct of company activities, work with the highest degree of professionalism and in accordance with the company’s code of Ethics and Business Conduct
•    Complying with annual budget allocation within respective territory
•    Perform additional duties as may be assigned.
 

Education and Experience

•    Bachelor’s degree
•    Experience in working with patient support HUB services
•    Minimum of three to five years of experience in the healthcare and/or pharmaceutical industry
•    Minimum of three years successful field reimbursement experience
•    Minimum of two years of experience working with buy and bill and/or specialty pharmacy networks
•    Ability to analyze and interpret regulations and legislation regarding coding, coverage and reimbursements
In-depth knowledge of the U.S. pharmaceutical market, specifically rare diseases.
•    Account Management and/or Reimbursement experience working with the provider office setting, building strong customer relationship
•    Reimbursement or relevant managed care experience (buy-and-bill, prior authorization, coding, and appeals processes)
•    Problem-solving ability to navigate challenging access scenarios and identifies solutions in a timely and efficient manner
•    Comfortable presenting in person or virtual to Healthcare practitioner office staff
•    Superior communication skills (written and verbal) and efficient follow-through
 

Knowledge and Skills

•    Strong relationship-building skills, with demonstrated ability to collaborate and operate across functions
•    Strong planning and organizational skills; demonstrated decision-making ability
•    Valid drivers license in good standing
•    Proficiency in Microsoft Office
•    Demonstrated highest ethical standards
•    Demonstrated effective problem-solving and decision-making capabilities
•    Ability to prioritize/multi-task effectively
•    Excellent verbal and written communication skills
 

Work Environment

This job operates in a professional remote environment. This role routinely uses standard office equipment such as computers, phones, photocopiers, filing cabinets and fax machines. Based upon job requirements, the employee may be required at times to attend meetings including travel out of state over weekends and nights. The employee must be able to freely operate and travel by car and train/plane modes of transportation. The employee is required to have a valid driver’s license and means of transportation.

Physical Demands

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. The employee must be able to fly via commercial air carrier.

This is largely a sedentary role; however, the employee frequently is required to stand; walk; use hands to finger, handle or feel; and reach with hands and arms; talk and hear. Occasionally is required to lift and/or move light to moderate weight up to 25 lbs.
 

Location/Travel

• This position is a remote position with proximity to a major airport
• This position requires approximately 20% travel

FLSA Classification

•    This position is considered Exempt.

EEO Statement

It is the policy of Recordati Rare Diseases to provide equal employment opportunity (EEO) to all persons regardless of race, color, religion, sex, sexual orientation, gender identity, or national origin. Further, Recordati Rare Diseases will not discriminate on the basis of any characteristic protected by federal, state, or local law. Recordati Rare Diseases will provide reasonable accommodations for a qualified individual with disabilities.

Disclaimer

This job description is not designed to cover or contain a comprehensive listing of the activities, duties or responsibilities that may be required.