Sr. Manager, Access & Reimbursement - (San Diego, CA) (field based)

This role will have a keen understanding of payer coverage at the customer and regional level and strong communication skills to appropriately educate on payer policies. This role will support the Neurology business unit, providing compliant access and reimbursement education to support an Eisai Alzheimer's product that will necessitate an understanding of buy-and-bill, miscellaneous J Code billing and specialty distribution procurement.

The ARM role will be a field-based individual contributor reporting into the Eisai Access and Reimbursement team under Patient Services/Market Access. Working closely with and reporting to the Associate Director, Access and Reimbursement, the ARM will be the functional lead for Access and Reimbursement activities across HCP offices, alternate sites of infusion care, State Societies, and Health Systems/institutions.

Key External Stakeholders

Health Care Professionals and stakeholders responsible for physician reimbursement and patient coverage and access issues. These stakeholders include, but are not limited to: Practice Managers, Financial Counselors, Pharmacy Managers/Directors, Business Administrators, State Societies, C and D Suite Health System personnel, and revenue cycle/integrity stakeholders.

Responsibilities

• Act as the point of contact for assigned customers with patient access and reimbursement needs/challenges to provide relevant education and support.
• Identify, triage, and escalate customer issues to relevant internal/vendor teams as required, and drive resolution.
• Develop strategies to address access and reimbursement needs across assigned customer group/region.
• Create and deliver high-level training programs to the sales force (e.g., general information on patient access issues, Eisai patient support programs, separation between sales and access/reimbursement).
• Proactively track payer trends; develop, coordinate, and execute plans to create and maintain treatment access for patients based on analyses of trends and information.
• Communicate current and pertinent field access/reimbursement information (e.g., customer feedback, payer coverage - medical/pharmacy benefit, access to product procurement, payer updates) to relevant internal/external stakeholders.
• Educate external stakeholders (e.g., physicians, office administrators, case managers, financial counselors, medical directors, billing personnel, pharmacists) as appropriate, on matters related to patient access to Eisai products.
• Possesses and maintains a valid driver's license and clean driving record.
• Ability to operate a motor vehicle safely and successfully is required.

Qualifications

• Bachelor's degree in related field (Master's preferred) with 8+ years of relevant experience in pharma/biotech industry.
• Previous patient access or reimbursement experience strongly preferred.
• Experience related to distribution, patient support programs, financial assistance, and patient assistance programs.
• Market Access payer and/or patient access support programs experience.
• Experience of the US healthcare system across one or more major payer segments (Medicare, Medicaid, Federal, and Commercial).
• Experience working with medical and pharmacy benefits, coverage policies, and reimbursement.
• Proven performance in earlier role.

As a condition of employment and an essential function of this field-based position, applicants must be able to engage in person with HCPs and other third parties at their offices, institutions and other appropriate locations on a regular basis. In order to gain in-person access, applicants selected for the position may be required to complete third parties' credentialing and/or entry requirements, which often include an attestation to and/or providing proof of having received certain vaccinations.

Skills

Communication & Cross-functional Influence, Critical Thinking & Business Agility, Industry & Regulatory (Market Access), Mentoring/People Development, Project Management, Reimbursement Knowledge.