Reimbursement Access Manager II - East

Essential Job Functions

• Serve as the subject matter expert on reimbursement and access issues impacting the company's rare disease products.
• Develop and execute strategies to overcome reimbursement and access barriers at the patient and provider level.
• Partner with field-based teams (e.g., Patient Access, Sales) to provide reimbursement education and support to healthcare providers.
• Manage relationships with specialty pharmacy partners to ensure efficient patient access.
• Track and analyze reimbursement trends, payer policy changes, and competitive landscape to inform market access strategies.
• Respond to reimbursement-related inquiries from internal and external stakeholders with speed and accuracy.
• Collaborate with the patient services team to resolve escalated patient access issues.
• Provide training to internal teams on reimbursement processes, coding, prior authorizations, denials, appeals, and payer policy nuances specific to rare disease.
• Support readiness activities for pipeline products, including developing access support materials and reimbursement tools.
• Offer subject matter expertise on trends, compliance, and other disciplines that impact the Patient Access role to help elevate the overall performance of the Patient Access team.
• Support the identification and implementation of strategies and programs that help the Patient Access team be maximally effective in their roles.
• Coach and mentor new members of the team.
• Identify key HCPs in need of additional support and conduct in-person meetings.
• Facilitate quarterly business reviews for high touch offices and provide detailed presentations.

Skills and Qualifications

• Bachelor's degree required; advanced degree in health policy, business, or life sciences a plus.
• Candidates with significant related experience (20+ years) in reimbursement, market access or patient access support may be considered in lieu of a bachelor's degree.
• 5+ years of experience in pharmaceutical/biotech market access or reimbursement roles, preferably with a focus on rare diseases or specialty products.
• Strong understanding of U.S. healthcare reimbursement systems, including Medicare, Medicaid, and commercial payers.
• Demonstrated experience working with HUB services, payer policies, specialty pharmacies, and patient support programs.
• Knowledge of coding and billing processes relevant to rare disease treatments (e.g., J-codes, CPT, ICD-10).
• Proven ability to work cross-functionally and manage multiple priorities in a fast-paced, evolving environment.
• A valid, US state-issued driver's license is required as occasional driving to client locations is a core requirement of this position.

Competencies

Written and Verbal Communications, Analytical skills, Problem Solving, Presentation skills, Teamwork & Collaboration, Customer Service focus, Adaptability, Professionalism.

Working Conditions

Position may require periodic evening and weekend work, as necessary to fulfill obligations. Periodic overnight travel. Ability to Travel up to 25%. Travel may include air and ground travel to HCP locations, and company meetings.