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Field Reimbursement Senior Manager Southwest(Texas,NM)

Company: Sobi - North America
Location: Albuquerque
Posted on: January 16, 2022

Job Description:

Statistics show that women and underrepresented groups tend to apply to jobs only if they meet 100% of the qualifications. Sobi encourages you to change that statistic and apply. Rarely do candidates meet 100% of the qualifications. We look forward to your application!

Role & Function

Reporting to the Director of Field Reimbursement, Doptelet, the Field Reimbursement Senior Manager (FRSM) is an important member of the Sobi Market Access team. The FRSM is a field-based, non-promotional resource for health systems, institutions, hospitals, and HCP practices/groups that serves as the key to help unlock patient access and resolve reimbursement issues. FRSM is a critical component of customer support and will rely on strong problem-solving skills to provide an outstanding customer experience for patients, providers and staff to ease the burden of access and improve access awareness with Doptelet. This role is expected to require approximately -70%-80% travel. Candidate must reside in territory.

Key Responsibilities

  • Customer Engagement: As a field reimbursement job, the Doptelet FRSM is expected to maintain a targeted account list and proactively engage accounts virtually & live on a regular call cycle. Three to four days each week would be in the field, directed at engaging accounts in their offices or virtually
  • Proactively and consistently working with assigned hematology/oncology accounts to build and maintain relationships with all relevant departments such as medication access, pharmacy, practice office managers and procurement/reimbursement departments
    • Where dispensing pharmacies exist, supporting access and reimbursement with these accounts and dispensing pharmacies through education of relevant access resources
    • Acting as the subject matter expert with a deep level of understanding of medical and pharmacy benefit reimbursement and access across all channels (Commercial, Medicare, Medicaid, Government) who educates and identifies compliant solutions to overcome patient access and reimbursement issues
    • Assisting HCP Offices, health systems, institutions, and hospitals, in understanding the mechanics of patient benefit verification, product ordering through Specialty Pharmacy, Specialty Distribution, CPT coding, C-Codes, S-Codes, and J-Codes
    • Acting as a bridge between the customer, the patient services team, and Sobi Sales and account management team to address access escalations and payer access issues
    • Working closely with the Doptelet Connect hub and the Care Coordinators to address escalations and access issues for hub patients
    • Working with local Sobi colleagues with a high level of cross-functional support for accounts in a defined geography
      • Demonstrates deep knowledge in:
        • Reimbursement and access across all channels (Commercial, Medicare, Medicaid, Exchange and Government) and is the subject matter expert of the payers in the markets they will support
        • All phases of specialty distribution, specialty pharmacy core services to assist with supporting access and product procurement
        • Healthcare structures, payment systems, and reimbursement methodology
        • Works collaboratively with internal and external business partners to win-Thinks and acts as a team; understands the nature and interdependencies of a matrix team environment and is able to effectively work cross-functionally to seize opportunities, resolve payer issues, improve customer experience, avoid bureaucracy, and maximize outcomes of strategies and key actions.
          • Internal Partners: Sales, Marketing, Patient Services, Trade Team, National and Regional Account Directors, Medical Affairs
          • External Partners: Builds relationships with: Health Systems, Institutions, Hospitals, HCPs, practice managers, reimbursement/access departments, and other customers who support reimbursement and access
          • Exhibits strong problem-solving skills related to complex patient access challenges across payers and specialty pharmacies
          • Educates health systems, institutions, hospitals, and HCP office staff about:
            • Patient financial assistance and alternative funding options to optimize patient access to Sobi's products
            • Prior authorization requirements, coverage status, and payer appeals requirements, processes, and timelines
            • Benefits investigation results, upon request, once patient authorization has been obtained
            • Comprehends and effectively demonstrates ability to conduct field-based customer support related to payer coverage and payment process (coverage navigation, payer reimbursement, medical billing and coding, specialty pharmacy, buy & bill, medical benefits).
            • Additional responsibilities include developing local solutions through account and market insight and providing Sobi leadership with market intelligence. This role inspires solution-oriented passion across cross-functional teams.
            • Adheres to all relevant regulatory and Sobi compliance & ethics guidelines and a willingness to coach to ensure a culture of compliance

              • A minimum of a B.A/B.S. required
              • A minimum five (5) years of work experience in Pharmaceuticals/Biotech/Medical Device with relevant experience in the following:
                • Patient journey navigation
                • Payer
                • Reimbursement
                • Medical billing and coding
                • Specialty pharmacy and distribution
                • Hub or Patient Services
                • Preference will be given to candidates with the following experience:
                  • Hematology/Oncology reimbursement experience
                  • Knowledge of key Hematology/Oncology providers and groups in the region you support
                  • Demonstrated ability to work accounts; specifically working to identify, engage and build relationships with key reimbursement contacts, access personnel and practice managers within identified Hematology/Oncology accounts.
                  • Industry Knowledge - proficient understanding of the pharmaceutical industry, Hematology/Oncology disease state and drug distribution process (e.g., medical, specialty pharmacy, managed care systems, etc.)
                  • Technical Expertise (Reimbursement and Patient Access) -Demonstrates strong technical expertise: Reimbursement and patient access knowledge with the ability to effectively convey knowledge to key stakeholders.
                  • Computer Skills - Ability to effectively use technology to support escalation work internal and external portals and databases
                    • Advanced Microsoft Excel skills that support analysis of large databases and manage a high volume of data
                    • Analytical Skills - Ability to analyze and leverage data/reports to identify trends and opportunities
                    • Demonstrates Passion, high energy, excitement, and a sense of urgency toward organizational purpose and values.
                    • Cultivates High IMPACT Partnerships with internal and external partners-Develops meaningful partnerships based on Sobi Core Values striving to earn and preserve the trust, respect, and admiration of all stakeholders.
                    • Values & Unlocks Collaboration --Cultivates an atmosphere of interdependence, collaboration, and reciprocal communication that creates a winning environment that inspires all to demand the 'best' from themselves because winning is fun and fulfilling.
                    • Business Savvy-Demonstrates a clear understanding of the current territory business situation, marketplace, and environment
                    • Understand HIPAA rules and regulations related to patient privacy
                    • Strong written and verbal communications as well as presentation skills
                    • This role is expected to require approximately -70%-80% travel

                      If you are interested in being considered for this role, then please attach an updated copy of your resume (as a MS-Word or PDF file) while submitting your application.

                      Why Join Us?

                      At Sobi, we refuse to accept the status quo. This is because we have witnessed first-hand the challenges facing those affected by rare diseases, and have used this knowledge to shape our business to find new ways of helping them.

                      As a specialized biopharmaceutical company, we are dedicated to rare diseases. And we see this focus as a strength. By effectively turning our research into ground-breaking treatments, we help make medicine more accessible and open up more possibilities for patients and more opportunities for those caring for them.

                      This has been our approach since day one, but we know we can't change the world of rare diseases on our own. Accomplishing this requires strong partnerships with patients, partners and stakeholders across the entire value chain.

                      Together, we define how our business can create solutions that serve the needs of those affected by rare diseases while facilitating sustainable growth.

                      An Equal Opportunity Employer

                      Sobi is an Equal Opportunity Employer and prohibits discrimination and harassment of any kind. All employment decisions at Sobi are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, national, social or ethnic origin, sex (including pregnancy), age, physical, mental or sensory disability, HIV Status, sexual orientation, gender identity and/or expression, marital, civil union or domestic partnership status, veteran status, family medical history or genetic information, family or parental status, or any other status protected by the laws or regulations in the locations where we operate.

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Keywords: Sobi - North America, Albuquerque , Field Reimbursement Senior Manager Southwest(Texas,NM), Executive , Albuquerque, New Mexico

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