
Sr Field Reimbursement Manager – HIV Prevention Dallas, TX
米国 - テキサス - フォートワース, 米国 - テキサス - ダラス, 米国 - オクラホマ - オクラホマシティ 営業正社員仕事内容
Gilead's mission is to discover, develop, and deliver therapies that will improve the lives of patients with life-threatening illnesses worldwide. The Senior Field Reimbursement Manager – HIV Prevention (Sr. FRM) plays a critical role in enhancing patient access to Gilead’s HIV treatments by supporting healthcare providers (HCPs), patients, and stakeholders in navigating the complexities of the healthcare system. The Sr. FRM HIV Prevention will provide in-person and virtual training on access and reimbursement topics, including payer policies, prior authorization processes, and claims submissions, ensuring that HCPs and their staff have the necessary tools to facilitate patient access. Additionally, the Sr. FRM HIV Prevention will manage pull-through strategies to resolve reimbursement issues, integrate patient support programs into practice workflows, and build strong relationships with key accounts serving large HIV patient populations.
As an expert in HIV market access, the Sr. FRM – HIV Prevention will remain informed about local and national payer policies and acquisition pathways, proactively addressing coverage and reimbursement challenges to ensure timely treatment access. Collaboration with internal teams, including Therapeutic Specialists (Sales), Marketing, and Patient Support, will be essential for aligning patient access strategies across the organization. The Sr. FRM – HIV Prevention will also engage in problem-solving to manage multiple projects and continuously identify opportunities for improving workflows, ultimately helping patients receive the necessary treatments without unnecessary delays.
This is a field-based role supporting the Dallas, TX area.
Specific job responsibilities:
• Develop and manage business relationships with key account stakeholders, including providers and specialty pharmacies, to facilitate patient access to Gilead’s products.
• Serve as a regional reimbursement expert, using influence mapping to identify and engage key customer accounts and communicate effectively with the appropriate stakeholders.
• Assist the internal patient support program team in enhancing hub and FRM processes, such as streamlining benefit verification and improving education on prior authorizations to expedite patient treatment initiation.
• Communicate changes in formulary or reimbursement processes for Gilead products, ensuring accounts receive timely support and education on requirements like medical exceptions and prior authorization.
• Excel at collaborating with cross-functional internal and external stakeholders to create instructional resources that help providers and office staff understand best practices in reimbursement processes.
• Increase coordination with the Gilead HUB to enhance communication channels between FRMs and case managers, providing efficient support to accounts.
• Identify bottlenecks in the patient journey that hinder therapy application and utilize technology tools to respond promptly to high-need cases.
• Cultural Sensitivity: Demonstrates open-mindedness and flexibility, being aware of cultural similarities and differences without assigning value, guiding the team to adapt to different environments and practices without being overly prescriptive.
• Patient-Centric Focus: Embodies a collaborative approach wholly dedicated to ensuring patient access and positive outcomes through teamwork, placing patient and team success at the forefront.
Basic Qualifications:
• Bachelor's Degree and Eight Years’ Experience
• OR
• Masters' Degree and Six Years’ Experience
• OR
• Ph.D.
Preferred Qualifications:
• BA/BS/RN with 8+ years of experience working for a major pharmaceutical organization on the field reimbursement team.
• MA/MS/PharmD with 6+ years of experience working for a major pharmaceutical organization on the field reimbursement team.
• Prior leadership experience is strongly preferred.
• Deep understanding of the relationship between payers, providers, and pharma companies in reimbursement.
• Experience engaging with and managing large, complex provider accounts.
• Familiarity with pharmacy benefits, 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 regions.
• 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, modeling 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, and organizational objectives, and holding them to account. They provide the support needed to remove barriers and connect their team to the broader ecosystem.