Field Reimbursement Manager, Central

Pharmacosmos Therapeutics Inc.


Date: 7 hours ago
City: Kansas City, KS
Salary: $162,000 - $189,000 per year
Contract type: Full time
Remote
About Us

We are a global, family-owned company driven by a passion for innovation. Building on our foundational expertise in carbohydrate chemistry and cell cycle biology, we develop innovative treatments for unmet patient needs, with a focus on iron metabolism and blood-related disorders.

With 700+ employees across the UK, Ireland, the Nordics, Germany, the USA, and China, we are committed to scientific excellence, patient care, and collaborative partnerships with the medical community.

Our Core Values Define Who We Are

  • People-Driven – We are a family-held company built on passionate, knowledgeable people. We value integrity, open-mindedness and respect and are guided by these values in all our endeavors. We respect each individual who becomes a part of our journey, from our employees and partners to our end-users. And we recognize that the strength in all our collaborations is trust.
  • Committed to Quality – Quality is our source of inspiration. Quality drives our results. It represents our aspiration for excellence and our focus on driving continual improvements. For our partners and end-users, quality must always be tangible in our products, processes and people. This way, quality is the promise we keep every day.
  • Innovating for Better Lives – Innovation is essential in our quest to improve the lives of humans. We seek to address unmet needs through our expertise in iron and carbohydrate-based pharmaceuticals. We believe in a holistic and collaborative approach to research and innovation, so we work together with the scientific and medical communities to set new standards.

We have continued our growth trajectory since we launched our first product in the US, Monoferric (ferric derisomaltose), through acquisitions, partnerships, and pipeline. Our R&D investments continue to leverage our core competencies, alongside our recent advancements in cancer care.

Join us in shaping the future of patient care through innovation and collaboration.

Job Purpose Purpose is to establish, maintain, and grow business relationships within designated hematology oncology practices, regional hospitals, integrated delivery networks (IDNs) and other emerging key accounts in the assigned geography to enhance reimbursement and patient access to Pharmacosmos products. This individual will work in a highly collaborative environment that includes field sales, market access, and regulatory.

Job Responsibilities

  • Pro-actively educate provider offices on Patient Services at the regional level in targeted accounts (oncology clinic/practice, hospital, IDN, emerging customers) by strategically prioritizing high utilization accounts
  • Assist customers in the Patient Services enrollment process using approved user guides, appropriate marketing collateral based on customer’s workflow.
  • Partner with targeted hematology/oncology practices and regional health systems to track status of customer co-pay claims to ensure timely payment and a claim adjudication rate of 100%.
  • Act as the subject matter expert on payer access and reimbursement by educating customers on Regional and National Payer coverage issues, coding changes and appropriate claims submission processes.
  • Proactively engage with customers on appropriate resources that could help overcome access barriers.
  • Integrate state step therapy exception request forms into the revenue cycle process for relevant accounts, where applicable.
  • Assist with determining coverage and access options available for Pharmacosmos products.
  • Work with hub and provider office to address payor reimbursement challenges by providing approved Letter of Medical Necessity template and information on each regional and National Payer’s appeals process.
  • Collaborate with hub, internal Sales and Market Access teams to triage reimbursement challenges from customers.
  • Utilize FRM platforms to identify at risk accounts and work cross-functionally on solutions and best positioning for value in partnering with Pharmacosmos.
  • Manage time effectively to maximize every opportunity, including but not limited to healthcare conferences, off-site customer engagement programs, customer meetings, to build and strengthen business relationships and provide solutions to key accounts,
  • Participate in strategic planning and evaluation sessions with Pharmacosmos senior leadership, sales, marketing, contracting and legal.
  • Manage internal and external customer relationships to ensure that key account needs are identified and addressed. Know what additional resources and stakeholders are needed and how to execute that process within accounts.
  • Understand and identify the short and long-term strategic vision and objectives within each assigned key account.
  • Actively maintain understanding of the drivers and trends within the healthcare industry that affect accounts and shape their overall business and buying decisions.
  • Maintain a high level of payer and related Managed Markets benefit structures, reimbursement mechanisms, legal and regulatory influences, health management programs, and product distribution knowledge necessary to accomplish goals.
  • Maintain accurate records of all account activity and provide management with regular reporting on reimbursement issues at the customer level.
  • Special projects as assigned by the Associate Director, Field Reimbursement Managers
  • Understand and utilize all relevant data analytics platforms to assist in identifying and overcoming reimbursement challenges and any access barriers
  • Other Duties as assigned.

Requirements For Position

  • Required 4-year bachelor’s degree; MBA preferred.
  • Required Experience with payer Reimbursement and Pharma patient services programs
  • Highly Preferred Experience with buy and bill pharmaceutical products
  • Highly Preferred Account management experience (oncology clinics and hospital systems
  • Preferred Oncology and Hematology therapeutic experience
  • Ability to establish and maintain executive relationships (C Suite and Pharmacy Director) in health systems and oncology clinics/practices.
  • A strategic outlook and critical thinking are essential along with strong clinical, financial, and analytical skills.
  • Solid understanding of the current environment and reimbursement trends in community oncology practices, including alternative payment models.
  • Superior communication, teamwork, and ability to work in a high matrix environment.
  • At minimum 50% travel

Competencies

  • Teamwork/Collaboration – Works toward common goals by supporting, encouraging, and sharing information with colleagues, both internal and external.
  • Communication— Speaks, writes, listens and presents information in a logical and articulate manner appropriate for the audience. Skilled in developing and delivering presentations and leading meetings.
  • Leadership Operate with high integrity in all matters with a proven ability to motivate teams and individuals; ability to build consensus and lead cross-functionally without authority.
  • Negotiation Confer with others to reach resolution; explore alternatives and positions to reach outcomes that gain support and acceptance of all parties.
  • Drive Produce consistent, high quality and quantity outputs and meaningful results that contribute to the agency mission and strategic goal on time.
  • Problem Solving Determine what is wrong in complex situations by identifying root causes and working with others to permanently fix problems with win/win solutions.

Attitude And Demeanor

  • Proud Pharmacosmos ambassador
  • Strong personal leadership
  • Inspire cross-functional transparency and collaboration
  • Customer-centric ‘can-do’ attitude and goal focused
  • Ambitious, independent, analytical, collaborative, loyal, organized

Flexibility

Our roles can evolve over time. Reasonable flexibility is, therefore, a key part of any job at Pharmacosmos. Significant variations in duties and responsibilities should be discussed between the employee and manager.

Additional Information

  • Requires budgetary responsibilities and discretion with confidential data
  • Traveling – minimum 50% of the time

All job requirements listed indicate the minimum level of knowledge, skills and/or experience necessary to perform the job proficiently. This job description is not to be construed as an exhaustive statement of duties, responsibilities, or requirements. Employees will be required to perform any other job-related duties as requested by their supervisor, subject to reasonable accommodation.

Pharmacosmos Therapeutics Inc. is committed to equal opportunity in employment. We value diversity which embraces all perspectives towards innovation and are committed to making PTI a truly inclusive place to work where everyone of us can be our best and true selves.

We select and employ qualified candidates in accordance with their competencies and skills to perform the duties of the job regardless of gender, gender identity or expression, ancestry, national or ethnic origin, marital status, race, religion, color, age, disability, sexual orientation, military, or veteran status.

Pharmacosmos Therapeutics Inc. has adopted a hybrid work schedule – a combination of being on-site at our Morristown, NJ offices along with remote working. Being present is critical to collaboration, innovation, productivity, employee well-being and engagement and enhances the Company culture.

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