The Field Reimbursement Manager (FRM) is a key field-based position within the Market Access team at Sobi, reporting to the Director of Field Reimbursement. Focused on the therapeutic area of Hematology/Oncology, this non-promotional role plays a critical role in facilitating patient access by addressing reimbursement challenges and offering resourceful support to healthcare systems, institutions, hospitals, and healthcare provider practices. Through proactive problem-solving and patient-centered service, the FRM supports healthcare professionals and their staff to alleviate access barriers, fostering an exceptional customer experience and increasing awareness of access solutions.
Including, but not limited to the following:
Customer Engagement
: The Hematology/Oncology Field Reimbursement Manager (FRM) will maintain a targeted account list and engage proactively with accounts both virtually and in person.
Relationship Building
: Work proactively with assigned customers to build and sustain relationships across key departments, including medication access teams, pharmacy, practice and office managers, and procurement/reimbursement departments.
Subject Matter Expertise
: Serve as the subject matter expert in pharmacy benefit reimbursement and access across all channels (Commercial, Medicare, Medicaid, Government). Educate and identify compliant solutions to address patient access and reimbursement challenges.
Support for Healthcare Providers
: Assist healthcare provider offices, health systems, institutions, and hospitals in understanding the mechanics of patient benefit verification, product ordering via Specialty Pharmacy and Specialty Distribution, CPT coding, and J-Codes.
Liaison Role
: Act as a bridge between customers, patient services, and Sobi's sales and account management teams to address escalated access and payer issues effectively.
Cross-Functional Collaboration
: Work closely with patient support hubs and case managers to resolve escalations and access issues compliantly. Collaborate with local Sobi colleagues to provide robust, cross-functional support for accounts within a defined geography.
Local Solutions and Market Insight
: Develop local solutions based on account and market insights. Provide Sobi leadership with actionable market intelligence, inspiring solution-oriented collaboration across cross-functional teams.
Specific Duties
Expertise in Reimbursement and Access
Demonstrates comprehensive knowledge of reimbursement and access across all channels, including Commercial, Medicare, Medicaid, Exchange, and Government. Serves as the subject matter expert on payers within the supported markets.
Understands all phases of specialty distribution and core services of specialty pharmacies to facilitate access and streamline product procurement.
Possesses a solid grasp of healthcare structures, payment systems, and reimbursement methodologies.
Collaborative Approach to Success
Works effectively with both internal and external partners to drive results, contributing to a cohesive team environment. Demonstrates an understanding of matrix team dynamics, ensuring cross-functional alignment to address payer issues, improve customer experience, reduce administrative barriers, and maximize strategic outcomes.
Internal Partners
: Collaborates closely with Sales, Marketing, Patient Services, Trade Team, National and Regional Account Directors, and Medical Affairs.
External Partners
: Builds and nurtures relationships with health systems, institutions, hospitals, healthcare providers, practice managers, and access/reimbursement departments to support access and reimbursement.
Advanced Problem-Solving Skills
Applies strong problem-solving abilities to address complex patient access challenges across payers and specialty pharmacies.
Educational Support for Healthcare Providers
Educates health systems, institutions, hospitals, and HCP office staff on:
Patient Service Program options to optimize patient access.
Prior authorization requirements, coverage status, and the payer appeals process, including timelines and requirements.
Customer Support for Payer Coverage Navigation
Demonstrates skill in providing field-based customer support, including navigating payer coverage and managing the specialty pharmacy fulfillment process.
Commitment to Compliance
Adheres to all relevant regulatory and Sobi compliance and ethics guidelines and fosters a culture of compliance through coaching and support.
Qualifications:
Qualifications
Education:
A minimum of a B. A/B. S. required
Experience:
A minimum five (5) years of work experience in Pharmaceuticals/Biotech/Medical Device with relevant understanding of the following areas:
Patient journey navigation
Payer coverage polices
Pharmacy benefit reimbursement
Specialty pharmacy and distribution
In office dispensing accounts
Hub and Patient Services
Preference will be given to candidates with the following experience:
Reimbursement experience
Hematology/Oncology experience
Critical Skills
Demonstrated ability to work accounts; specifically working to identify, engage and build relationships with key reimbursement contacts, access personnel and practice managers within identified accounts.
Industry Knowledge - proficient understanding of the pharmaceutical industry, disease state and drug distribution process (e. g. , medical, specialty pharmacy, managed care systems, etc. )
Understanding of Medicare and Medicaid drug coverage and current and pending changes to drug coverage benefits
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 a.
US - US
November 16, 2024
The Field Reimbursement Manager (FRM) is a key field-based position within the Market Access team at Sobi, reporting to the Director of Field Reimbursement. Focused on the therapeutic area of Hematology/Oncology, this non-promotional role plays a critical role in facilitating patient access by...
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The Field Reimbursement Manager (FRM) is a key field-based position within the Market Access team at Sobi, reporting to the Director of Field Reimbursement. Focused on the therapeutic area of Hematology/Oncology, this non-promotional role plays a critical role in facilitating patient access by...
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