What are the responsibilities and job description for the Field Reimbursement Manager position at Lifelancer?

Job Title : Field Reimbursement Manager (Little Rock)

Job Location : Little Rock AR USA

Job Location Type : Remote

Job Contract Type : Fulltime

Job Seniority Level : MidSenior level

Why Endo

We want the best and brightest people at Endo to help us achieve our mission to develop and deliver lifeenhancing products through focused execution. Our nearly 3000 global team members understand the important role we play in delivering healthcare and are dedicated to supporting each other as we work to bring the best treatments forward. Our shared values of Integrity & Quality Innovation Drive Collaboration and Empathy guide our team and enable us to deliver upon our vision of helping everyone we serve live their best life.

At Endo we are building a diverse equitable and inclusive workplace and we are looking for talented individuals to join our team.

Job Description Summary

The Field Reimbursement Manager (FRM) is a critical frontline member of the Endo Access and Reimbursement team who represents Endo’s interest with Xiaflex Testopel Aveed and Supprelin LA with HCP accounts as well as all internal Endo stakeholders and field sales personnel. The FRM will be an expert and provides education training and handson assistance related to access of the above products.

Job Description

The Field Reimbursement Manager (FRM) position is a critical frontline member of the Endo Access and Reimbursement Team. The main driver of Endo Pharmaceuticals and Patient Access is patients and assisting provider offices to help their patients get access to care to get them back to living their best lives. The FRM role is a fieldbased position whose job is to minimize access and reimbursement barriers for patients and providers.

Within their geography the FRM provides access and reimbursement education to physician office personnel billing staff / companies HCPs as well as anyone involved in the process of utilizing the product with the intention of minimize barriers and increasing access to care. FRM education homes in on Endo Specialty therapies how to buy and bill our products acquire through specialty pharmacies and educate on office processes. FRMs also support provider offices on a reactive basis by providing education and guidance in response to PA denials and claim denials and / or underpayments. The FRM will leverage all data analytic tools to minimize delay in receiving treatment by working with internal and external customers.

Endo Branded – Specialty

Key Accountabilities :

Provider Account Support

Subject matter expert for all reimbursement / access and acquisition logistical aspects of a high touch biologic medication for an orphan disease and testosterone products with multiple acquisition options within a changing payer landscape. This includes payer policies prior authorization requirements denial and appeal process peer to peer and other education required to navigate access for the appropriate patients.
Assists HCP offices with questions related to Buy / Bill BI management. Educate / Assist with Specialty Pharmacy (SP) understanding expectations and logistics. Continually educate office staff on appropriate steps educate on the importance of chart documentation keep offices up to date on payer policies for Endo products and triage issues to the appropriate HUB and SP.
Primary responsibilities include :
Managing patient assistance and reimbursement support services offered to providers and related to patient access to buy / bill products.
Coordinating with Endo’s patient support services program representatives.
Educating office staff on the use of Buy / Bill products patient assistance and reimbursement support services.
Participating in sales training related to product reimbursement.
Utilizing data to critically think through acquisition challenges from a variety of outlets including SP Specialty Distributors and Title sales.
Assist new offices from a reimbursement perspective to inform them about reimbursement issues as well as providing education on various MARC approved resources pertaining to reimbursement acquisition and coding.
Act in a compliant manner at all times.

Specialty Pharmacy (SP) Support

FRMs work closely with the external and internal customers to trouble shoot any SP related issues. FRMs work closely with their NAE partner to manage any customer related issues directly with the SP’s.

SP experience is critical. Each FRM should be an expert SP logistics and operations.

FRMs must be able to analyze data and know how to make that data into actionable steps to facilitate patient access to ENDO products.

Work closely with SP’s to understand logistical issues that arise and provide MARC approved resources and programs to facilitate patient access as well as communicate with SP’s to find resolutions to issues that arise at the SP.

Identify gaps in knowledge of accounts from a SP process and help provide education for the account and physician.

Develop short and longterm account plans for key accounts with the goal of smoothing out the process of acquiring drug to optimize acquisition and patient journey

Internal Partnerships

Consistent reliable timely and highquality support of the field as well as all other internal commercial functions.

Strong leadership role to the field teams by establishing a solutionsoriented approach working with your Sales Representatives / ASMs to build and execute local plans to overcome barriers to Buy / Bill products access. Specific examples include :

Identify in conjunction with the field specific targeted accounts where the FRM will assist with product acquisition or SP dispense.

Partner with the ASMs to build local business plans; participate in district business reviews as the expert resource on the reimbursement landscape from regional district state and local perspective.

Provide the teams with actionable feedback (across the organization) on support programs such as the Helpline copay card SPP performance so as to guide changes to improve access.

Help educate the internal customers on managed market dynamics specific to SP’s / SD’s as well as local payor issuesneeds. Track customer trends in order to help inform internal business decisions e.g. Health care policy changes.

Proactively use business analytics to understand common logistical issues in top accounts and proactively develop plans for education and to find solutions for better patient access to all supported specialty products. Ensure alignment with ASM and District Strategy.

Provide support to sales representatives ASMs and Internal Stakeholders on rules of engagement to educate and further clarify what is appropriate.

Advocacy

Works with the field to identify potential payer advocates and supports the National Account Management team on issues relating to medical policy development and execution at the HCP level.

Ensure all Endo approved promotional speakers have an indepth understanding of billing / coding logistics and payer coverage.

Other duties as assigned.

Qualifications

Education & Experience

BS or equivalent is required; MBA or advanced degree preferred.

5 – 7 years of relevant experience in the Biopharma industry required.

Three years’ experience in 3rd party reimbursement and managed care experience

Significant experience in patient access support i.e. copay programs HUB management payer experience etc.

Superb knowledge and operationalizing experience of buy & bill and SP pathways.

Previous experience working with vendor relationships desirable.

Previous experience managing customer interactions required.

Previous sales management and / or account management experience highly desirable.

All newly hired FRMs should enter at this level regardless of their tenure or experience elsewhere.

Knowledge

Systemic understanding of the global payer and distribution environment in particular physician administered biologics in the U.S.

Understanding of coverage coding (diagnostic procedural and product) payment and reimbursement requirements and policies.

Knowledge / expertise in commercial payer policy.

Knowledge / expertise in Local Coverage Determinations (LCDs) per each regional MAC for all ENDO products.

Knowledgeable on Medicare billing / coding and appeal process. ASP WAC as well as Sequestration; interpret and understand Medicare EOBs and CMS 1500 forms.

Understands the legislative legal and regulatory environments and anticipates potential impact to Endo.

Solid understanding of coverage policy creation interpretation and management.

Skills & Abilities

Significant sales experience in the biologic (injectable) market.

Possess a strong understanding of commercial payers Medicare Part B and D and Medicaid; particularly in assigned geography.

Ability to have payer conversations with commercial and government payers drawing on the understanding of Endo products payer policy appeals process and the payer landscape.

Leverage all resources (Tableau and other portals) to develop and execute account support and educate sales colleagues.

Ability to synthesize clinical literature and target product profile in order to understand implications for value to payers patients and health care providers and Endo.

Superior verbal written and presentation skills to effectively convey strategic and technical market access information with an ability to condense complex information into concise outputs and direction.

Ability to balance external stakeholders’ wants with Endo needs.

Hands–on operational reimbursement experience – inhouse and outsourced experience desirable.

Demonstrated ability to work with multiple stakeholders in a collaborative and constructive manner. Establishes relationships with appropriate field personnel accounts payers and vendors.

Model Endo’s vision and core values and encourages others to foster a culture of compliance.

Conduct business at the csuite level for large hospital systems and can address more routine policy and State Medicaid and Medicare problems.

Physical Requirements

Significant travel involved.

Disclaimer : The above statements are intended to describe the general nature and level of work performed by employees assigned to this job. They are not intended to be an exhaustive list of all duties responsibilities and qualifications. Management reserves the right to change or modify such duties as required.

Commitment to Diversity Equity and Inclusion :

At Endo our diversity unites and empowers us as One Team and we are committed to cultivating and valuing each person’s unique perspective. We actively promote a culture of inclusion that draws strength from our broad spectrums of diversity including race ethnicity religion gender identity or expression national origin color sexual orientation disability status age and all our other unique characteristics qualifications demonstrated skills achievements and contributions backgrounds experiences cultures styles and talents.

EEO Statement :

At Endo we firmly believe in the principles of equal employment opportunity and strive to create an atmosphere where all employees regardless of their race color creed religion sex gender identity or expression sexual orientation national origin genetics disability (including pregnancy) age or military or veteran status feel valued respected and empowered. Our commitment to EEO extends to every aspect of employment including recruitment hiring training promotions compensation benefits transfers terminations and all other employment practices. We are dedicated to ensuring that all employment decisions are based on qualifications skills and merit.

Lifelancer ( ) is a talenthiring platform in Life Sciences Pharma and IT. The platform connects talent with opportunities in pharma biotech health sciences healthtech and IT domains.

For more details and to find similar roles please check out the below Lifelancer link.

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Key Skills

Time Management,Construction Experience,Managed Care,Management Experience,Microsoft Outlook,Utilization Management,Case Management,Pediatrics Experience,Salesforce,Relationship Management,Leadership Experience,Supervising Experience

Employment Type : Full Time

Vacancy : 1

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