Field Reimbursement Manager

Description

Summary:

Pacira is the leading provider of non-opioid pain management and regenerative health solutions dedicated to advancing and improving patient outcomes. Pacira Pharmaceuticals currently has an opening for a Field Access Manager.

Essential Duties & Responsibilities:

The following statements are intended to describe the general nature and level of work being performed by an individual assigned to this job. Other duties may be assigned.

The Field Access Manager will serve as the regional Zilretta/Iovera access resource in support of product access. This individual will work closely with their assigned field sales team to identify health plan access pull through opportunities, resolve customer access escalations and provide customer education upon request.

Job Responsibilities:

With a solid educational foundation of Zilretta/Iovera, educate customers about product acquisition, health plan access requirements and coding, and Pacira service offerings.

Establish relationships and serve as a resource for patient access stakeholders including office management, institution administrators, billing and coding staff and nurses.

Work closely with the Sales Leadership and field sales representatives to appropriately support health care providers with their reimbursement needs

Fully understand Zilretta/Iovera health plan access and policies. Effectively communicate this information to internal and external stakeholders

Understand and be able to help providers with reimbursement issues that work within our core classes of trade:

• Medicare (Part A, B, C, D; Carriers)
• Commercial Managed Care (Regional Plans)
• Medicaid (Fee for Service, Managed Care Organizations)
• Veteran’s Administration (VISNs)
• TRICARE Regional Offices
• Specialty Pharmacy & Pharmacy Benefit Managers
• ACOs and other Integrated Delivery Networks (IDNs)
• Advocacy, consumer, provider, and treatment systems groups
• Respond with a sense of urgency to field sales team and service HUB provider customer escalations, questions and recommendations related to access and reimbursement.
• Report access trends and customer issues internally. Recommend regional solutions for any product access challenges. Use available tools and resources to monitor and evaluate industry/health plan access trends and communicate relevant information to teams that are impacted (e.g., sales, national account team, and commercial leadership)
• Facilitate live training and education for sales partners as well as key customer locations.
• Must achieve and maintain compliance with all applicable regulatory, legal, and operational rules and procedures.
• Collaborate with Market Access operations teams (e.g. HUB, Trade, Payer, & Strategic Accounts), to identify customer needs and innovative, effective solutions.
  
  

Interaction:

The incumbent will work closely with internal departments, such as, Marketing, Field Sales, Payer/Employer, Strategic Accounts, Medical Affairs, and HEOR, as well as with external constituents such as commercial or government payers, various associations and its members and third party payer/employer consulting organizations.

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

• In depth knowledge of public and commercial health plans including reimbursement methodologies, coding, medical and pharmacy benefit design, and the health plan policy decision-making process.
• Understanding of healthcare provider site of care operational dynamics, systems, and the buying processes for pharmaceutical medical benefit products.
• Experience educating provider offices in prior authorizations and understanding utilization management criteria.
• Ability to work with multiple stakeholders in a collaborative and constructive manner
• Analytical skills applied to synthesize information from several data sources (e.g., service team, sales feedback, and health plan coverage data) and use it to identify regional trends and sales team objectives.
• Strong verbal, written and presentation communication skills with an ability to communicate complex access and reimbursement information, according to Flexion compliance requirements, to a healthcare audience.
• Experience with Specialty Pharmacies preferred.
  
  

Education and Experience:

• Bachelor’s Degree
• 7 years’ experience in a pharmaceutical commercial environment.
• Demonstrated experience in a pharmaceutical field market access, trade, reimbursement services or related role; or 3 years of experience in a sales or sales leadership role.
• Buy and bill experience
• The ability to travel 75% - 80% of the time
  
  

Physical Demands:

While performing the duties of this job, the employee is regularly required to sit, talk, move between spaces, reach with hands and arms, and stoop. Close vision and the need to focus on computer screen, use of hands, fingers and wrist to type on keyboard and manipulate mouse.

• Ability to travel 70% plus
  
  

Work Environment:

Work from home or remote locations such as airports, hotels and off-site meetings. This position may or may not be a typical office setting, staff in cubicles. Noise level is moderate such as consistent printer, telephone ringing, conversation, airport paging and airplane noise.

The annual base salary for this position ranges from $165,000 to $172,500. The base salary range represents the anticipated low and high of the Syneos Health range for this position. Actual salary will vary based on various factors such as the candidate’s qualifications, skills, competencies, and proficiency for the role.  In addition, some positions may include a company car or car allowance and eligibility to earn commissions/bonus based on company and / or individual performance.

At Syneos Health, we are dedicated to building a diverse, inclusive and authentic workplace. If your past experience doesn’t align perfectly, we encourage you to apply anyway. At times, we will consider transferable skills from previous roles. We also encourage you to join our Talent Network to stay connected to additional career opportunities.

Why Syneos Health? Our ability to collaborate and problem-solve makes a difference in patients’ lives daily. By joining one of our field access teams, you will partner with industry experts and be empowered to succeed with the support, resources, and autonomy needed to successfully navigate the complex reimbursement landscape. The diversification and breadth of our new and existing partnerships create a multitude of career paths and employment opportunities. Join our game-changing, global company dedicated to creating better, smarter, faster ways to get biopharmaceutical therapies to patients Experience the thrill of knowing that your everyday efforts are contributing to improving patients’ lives around the world.

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Syneos Health companies are affirmative action/equal opportunity employers (Minorities/Females/Veterans/Disabled)

Syneos Health has a voluntary COVID-19 vaccination policy. We strongly encourage all employees to be fully vaccinated. Additionally, certain local governments or Syneos Health customers may have vaccine requirements that apply to some of our employees. These employees are required to submit proof of vaccination to Syneos Health and maintain compliance with these requirements.

At Syneos Health, we believe in providing an environment and culture in which Our People can thrive, develop and advance. We reward and recognize our people by providing valuable benefits and a quality-of-life balance. The benefits for this position will include a competitive compensation package, Health benefits to include Medical, Dental and Vision, Company match 401k, flexible paid time off (PTO) and sick time. Because certain states and municipalities have regulated paid sick time requirements, eligibility for paid sick time may vary depending on where you work. Syneos Health complies with all applicable federal, state, and municipal paid sick time requirements.