Key Responsibilities: Act as a compliant subject matter expert (SME) in reimbursement, access, and specialty distribution for assigned geography. Provide education to HCP offices on coverage status, prior authorization processes, appeals, and alternate funding options for uninsured/underinsured patients. Build and maintain productive relationships with HCPs, office staff, and health system stakeholders. Analyze regional/local payer coverage trends, reimbursement criteria, and payer mix. Provide guidance on specialty pharmacy services and help customers navigate complex distribution channels. Partner with Patient Support to ensure accurate benefit investigations and streamlined patient onboarding. Collaborate with internal partners to build local access strategies aligned with business objectives. Develop and execute territory-level business plans using strategic customer insights. Participate in field-based problem-solving, including reimbursement issue resolution and case escalation when needed. Identify process improvements to enhance patient access and provider satisfaction. Maintain compliance with legal/regulatory/company policies, including patient privacy and promotional conduct. Requirements: Bachelor's degree in an allied health field preferred or equivalent work experience. 8+ years in pharma/biotech/related healthcare industry. Prior reimbursement experience required: substantial experience with prior authorizations and navigating the US payer landscape. 3-6 years supporting Specialty Pharmaceuticals/Biologics. Deep understanding of reimbursement, access, and specialty pharmacy operations. Experience supporting product launches or guiding patients through insurance approval processes. Strong understanding of Specialty Pharmacy distribution models and patient services programs. Knowledge of HIPAA and other federal/state laws governing patient confidentiality and healthcare communications. Bilingual skills (English/Spanish) highly desired. Proven track record supporting complex therapies in rare or specialty conditions. Exceptional communication/interpersonal skills; builds trust with providers and internal partners. Comfortable with ambiguity and managing multiple cases in real time. Digital fluency with CRM platforms; comfortable educating patients on technology-enabled tools, including AI-based platforms. Benefits: 401(k) with company match; comprehensive medical/dental/vision; company-paid Life and AD&D; company-paid short/long-term disability; voluntary Pet and Legal Insurance; EAP; employee discounts and professional development; HSA and FSA; accident/critical illness/hospital indemnity; paid parental leave and mental health resources; performance-based incentive compensation. Compensation: Annual base salary: $185,000-$190,000. #J-18808-Ljbffr
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