Senior Field Reimbursement Manager - Upper Midwest Region

职位描述

Gilead's mission is to discover, develop, and deliver therapies that will improve the lives of patients with life-threatening illnesses worldwide. The Senior Manager (SM) Field Reimbursement Manager (FRM) will be part of a team that is changing the world and helping millions of people live healthier, more fulfilling lives. The SM FRM is a critical front-line member of the Gilead Field Reimbursement Team. The primary purpose of this role is to serve as a field-based, product access specialist that partners with provider organizations to optimize patient access to Gilead PBC/Liver products, develop impactful relationships, and provide appropriate reimbursement support to HCPs and office staff.

The person in this role proactively provides in person and virtual education to defined accounts within their assigned regions on a wide range of access and reimbursement topics for aligned portfolio product(s). The SM FRM will primarily focus on accounts serving large volumes of patients needing access support. The SM FRM will also take a pivotal role in building relationships with key accounts to offer patient support.

The person in this role is responsible for managing the pull-through of access and reimbursement strategy within their assigned accounts. SM FRMs are expected to have deep expertise in communicating requirements and addressing barriers associated with local payer policy coverage, multi-channel acquisition pathways, billing and coding (as needed), claims processing, reimbursement, and awareness of manufacturer support programs into a range of account workflows. FRMs will continually need to demonstrate a keen ability to problem solve and manage multiple projects.

Internal stakeholders with whom the SM FRM will interact include other Gilead field associates, such as Therapeutic Specialists (Sales), representing Gilead with the highest integrity in accordance with Gilead Values and Behaviors. The SM FRM will also be required to coordinate and communicate cross-functionally within the organization (e.g., Patient Support, Marketing, Public Affairs, Government Affairs, Trade, and other applicable third-party affiliates).

The position is a remote/field-based role that covers the Upper Midwest Region (IL, WI, MN, ND,SD, WY, NE, IA KS,CO). Candidate must reside within 10 miles of their region’s borders.

Specific job responsibilities:

• Develop and manage business relationships with key account stakeholders such as providers, and specialty pharmacies and their employees.

• Serve as a regional reimbursement expert, using influence mapping to better identify key customer accounts and reach the right stakeholders.

• Assist internal patient support program team in identifying ways to positively enhance hub & FRM processes, with accompanying internal and external change management. Examples include: streamlining the benefit verification process, and educating on prior authorizations to initiate patients on treatments faster. Oversee processes for providers to enroll patients in Gilead patient support programs. Work directly with case managers to resolve complex patient access questions in a timely manner.

• Proactively communicate changes that may arise in the formulary or reimbursement processes for Gilead products and ensure accounts are supported. Provide education on reimbursement processes and requirements such as medical exception and prior authorization.

• Partner with internal stakeholders to design instructional resources for the FRM team to share with providers and their office staff to educate on best practices in reimbursement processes. Communicate local and state policy changes that could cause pitfalls / bottlenecks from a reimbursement standpoint. Field pulse check surveys to understand customer perceptions of Gilead reimbursement support.

• Increase coordination with Gilead HUB by streamlining communication channels between FRMs and case managers. Collaborate closely with internal matrix partners to provide focused, efficient, and impactful customer experiences across the field-team. Help develop policies around communication best practices.

• Identify stages in the Gilead patient journey causing bottlenecks that prevent application of therapies. Employ technology tools (such as triaging apps and data portals) to respond quickly to high-need cases that are brought up the chain of command.

Basic Qualifications:

• Bachelor's Degree and 10 Years' Experience OR

• Master's Degree and 8 Years' Experience OR

• PhD and 2 Years' Experience

Preferred Qualifications:

• BA/BS/RN with 9+ years of experience working for a major pharmaceutical organization on the field reimbursement team.

• MA/MS/PharmD with 7+ years of experience working for a major pharmaceutical organization on the field reimbursement team.

• Prior leadership experience is strongly preferred.

• Deep understanding of relationship between payers, providers, and pharma companies in reimbursement process.

• Experience engaging with and managing large, complex provider accounts.

• Familiarity with pharmacy benefit, specialty payer landscape and reimbursement pathways (commercial, Medicare, Medicaid).

• An understanding of local and state policy changes effect on reimbursement policies.

• Preferably have experience with specialty pharmacies and utilizing a HUB service

• A willingness to travel 75% of the time across designated region. This is a field-based role where in-person meetings with key stakeholders are crucial to success.

People Leader Accountabilities

• Create Inclusion - knowing the business value of diverse teams, modelling inclusion and embedding the value of diversity in the way they manage their teams.

• Develop Talent - understand the skills, experience, aspirations and potential of their employees and coach them on current performance and future potential. They ensure employees are receiving the feedback and insight needed to grow, develop and realize their purpose.

• Empower Teams - connect the team to the organization by aligning goals, purpose, organizational objectives and holding to account. They provide the support needed to remove barriers and connect their team to the broader ecosystem.