Job Description Summary
#LI-Remote
The AD, Access & Reimbursement, NPS CV is in Houston, TX geography. This is a remote & field-based role that covers the following, but not limited to: Houston, Spring, and Katy, TX. Associate must reside within territory, or within a reasonable daily commuting distance of 60 miles from territory.
The Associate Director, Access & Reimbursement (ADAR) is a field-based role that proactively provides in person (or virtual as needed) education to defined accounts within their assigned geographies on a wide range of access and reimbursement topics and needs (see below) in support of aligned product(s) strategy. ADARs primarily focus on accounts with increased process and workflow complexity, typically including centralized and decentralized systems of care, integrated delivery networks, academic medical institutions, large multi-provider specialty practices, and alternate sites of care.
ADARs will serve as the patient access and reimbursement lead in business-to-business conversations with account executives. The ADAR role is responsible for managing the pull-through of access and reimbursement strategy and downstream operations within their aligned accounts. ADARs are expected to have deep expertise in communicating requirements and addressing barriers associated with local payer policy coverage, multi-channel acquisition pathways, billing and coding education (as needed), claims processing, reimbursement, and integration of manufacturer support programs into a range of account workflows. ADAR will continually need to demonstrate a keen ability to problem solve and manage multiple projects.
ADARs partner closely with other Novartis Pharmaceuticals Corporation (NPC) field associates, including Customer Engagement (Sales) and Market Access, representing NPC with the highest integrity in accordance with NPC Values and Behaviors. ADARs will also be required to coordinate and communicate cross-functionally within NPC (e.g., Patient Support Center, Customer Engagement, Marketing, Market Access, Public Affairs, State & Government Affairs, Trade, Specialty Pharmacy Account Management, and other applicable third-party affiliates).
Job Description
Key Responsibilities :
- Interact with large, complex accounts to support patient access within their aligned therapeutic area product(s), proactively provide face-to-face education on programs to providers and staffin order tosupport integration of those products into office processes and workflows.
- Work with key members of therapeutic area offices (e.g., executives, providers, administrators, billing and coding staff, claims departments, revenue cycle managers)in order toappropriately support patient access to products.
- Ability to analyze problems and offer solutions. Understand specifics and support questions associated with patient reimbursement and provide support on reimbursement issues with third party payers at the provider-level. Analyze account reimbursement issues (as needed).
- Supports pullthrough onlocal coverage decisions to enable meaningful patient access within the system.Proactively communicate policy changes or issues that could potentially affect other departments.
- Maintainexpertisein regional and local access landscape,anticipatingchanges in the healthcare landscape, and act as their aligned therapeutic area product(s) reimbursement expert (as needed).
- Interface with Patient Support Center (hub) and Access & Reimbursement Managers on important matters related to patient case management, including tracking cases, issue resolution, reimbursement support, andappropriate officestaff education.
- Collaborate with aligned cross-functional associates within NPC (see above) to share insights on customer needs and barriers for their aligned therapeutic area product(s) related to access and reimbursement.
- Responsible for educating HCPs using approved materialsregardingacquisition pathways for Novartis products. Educate on buy-and-bill end-to-end processes, workflows, and facility pull-through in complex accounts, including scenarios of centralized and decentralized acquisition, and use of alternative channels such as white bagging, clear bagging, brown bagging, and alternate site of care for administration.
Buy and Bill Specific
- Assessaccesssituation within the assigned geography and developappropriatePlan of Action (POA). Communicate POA toappropriate personnel.
- Responsible for educating HCPs using approved materialsregardingacquisition pathways for Novartis products. Educate on buy-and-bill end-to-end processes, workflows, and facility pull-through in complex accounts, including scenarios of centralized and decentralized acquisition, and use of alternative channels such as white bagging, clear bagging, brown bagging, and alternate site of care for administration.
- Educates relevant stakeholders onlogisticsrelated to ordering, payment, inventory, and product returns & replacement.
- Analyze reimbursement issues,anticipatingchanges in the healthcare landscape, and act as the designated reimbursement expert for offices and field teams.
- Accountable for engagement with non-prescribersin regards toNovartis medicines, for example pharmacy, system leadership, financial counselors, office administrators, revenue cycle managers, etc.
Minimum Requirements:
- Education:Bachelor’s Degreerequired. Business and/or biological science education preferred. Advanced degree preferred.
- 5+ Years of experience in pharmaceuticals / biotech industry focusedinPatient Services, Market Access, Sales, and/or account management. With 2 of those years being in a Patient Services practice support role for a specialty product(s).
- Experience working withhighly complexpractices and/or health systems toestablishaccess and acquisition pathways.
- Strategic account management experienceusinga proactive approach toanticipateaccess hurdlesimpactingaccounts and patient access.
- Deepexpertiseand experience integrating manufacturer-sponsored patient support programs.
- Experience with specialty productsacquiredthrough Specialty Pharmacynetworks.
- Knowledge of reimbursement pathways (specialty pharmacy, buy-and-bill, retail).
- Candidate must reside within territory, or within a reasonable daily commuting distance of 60 miles from the territory border. Ability to travel 60-80% over a broad geography is required, with the ability to drive and/or fly within the territory. Must have a valid driver’s license.
