Access and Fees Manager - NPS Enterprise - Puerto Rico - Remote (2023)

job identification

374137 BR

25 mei 2023

EU

For six decades, we've worked to improve cardiovascular health by transforming standards of care and introducing innovations in areas of high unmet need.

CVD is the number 1 cause of death in the world. CVD is responsible for more deaths than all cancers combined. And after decades of decline, the number of deaths is rising again. There is some evidence that the pandemic has led to deteriorating CV outcomes. This burden is likely to increase and overwhelm society if we do not make significant changes to reduce the rising incidence. ASCVD is responsible for 85% of deaths from cardiovascular disease, and addressing key risk factors such as elevated LDL-C and Lp(a) can reduce the risk of heart attack and stroke.

Job offer:
The Puerto Rico Business Access and Reimbursement Manager is a remote/field role covering the entire island of Puerto Rico. The applicant must reside in the territory or within a reasonable distance of 60 miles from the border of the territory. Knowledge of Spanish is required

The Access and Reimbursement Manager, Enterprise (ARM) is a field-based role that proactively provides in-person (or virtual as needed) education to defined accounts within their assigned regions on a wide range of access and reimbursement topics and needs (see below) to support of strategy product compliance. The NPS Enterprise team can focus on multiple therapeutic areas and will deploy based on business needs; but the therapeutic area of ​​immediate focus is cardiovascular.

ARM will serve as the primary point of contact and leader for issues related to access and reimbursement support and will be responsible for the local go-to-market specialist in payment policy coverage, multi-channel purchase journeys, billing and coding, claims processing, reimbursement and integration of manufacturer support programs into various account workflows. In addition, the ARM must continually demonstrate strong problem-solving skills, analyze access and reimbursement issues and opportunities, and proactively communicate changes in the healthcare environment.

ARM will work closely with other Novartis Pharmaceuticals Corporation (NPC) field partners, including customer engagement (sales) and market access, representing NPC with the highest integrity in line with NPC values ​​and behavior. The ARM will also need to coordinate and communicate between functions within NPC (e.g., patient center, customer engagement, marketing, market access, public relations, state and government affairs, commerce, specialty pharmacy account management, and other applicable third-party services). branches).

Your main responsibilities:

Interact within assigned accounts to support patient access to their therapeutic products by proactively providing face-to-face education about product-specific programs to providers and staff to support the integration of those programs into Office processes and workflows.

Collaborate with key office members in the therapeutic area (e.g., vendors, administrators, billing and coding staff, claims departments, revenue cycle managers) to appropriately support patient access to products.

Ability to analyze problems and propose solutions. Understand the details and related issues related to payment policies (e.g. usage management, denials and appeals), drug procurement and inventory management, and patient/practice reimbursement (e.g. payment, administration, drug claims). Analyze account chargeback issues and opportunities (if applicable). Identifies local, regional and national trends and partners with internal and external goals to support patient recovery.

Maintain expertise in the regional and local access landscape and anticipate changes in healthcare.

Collaborate with aligned cross-functional partners within NPCs (see above) to share insights on customer needs and barriers to access and reimbursement for your aligned therapeutic area products.

Ensure a thorough understanding of NPC policies and requirements and perform all responsibilities with integrity and in a manner consistent with the Company's guidelines and prescribed values ​​and behaviors. Properly handle patient identifiable information (PII) (understand and ensure compliance with HIPAA and other privacy laws and regulations and internal company compliance guidelines).

Purchase and specific invoice

Assess the access situation within the assigned geographic area and develop an appropriate action plan (POA). Communicate POA to the appropriate personnel.

Responsible for setting up the desired purchasing channels. Educate and support end-to-end procurement and billing processes, workflows and asset allocation in complex accounts, including centralized and decentralized procurement scenarios and the use of alternative channels such as white bags, clear bags and brown bags. and sites of alternative care for administration.

Inform relevant stakeholders about logistics related to ordering, paying, inventory, and returning and exchanging products.

Analyze reimbursement issues and opportunities, anticipate changes in the healthcare environment, and act as the preferred reimbursement expert for practice and field teams.

Responsible for working with non-prescribers e.g. Pharmacy, System Leadership, Financial Advisors, Office Administrators, Revenue Cycle Managers, etc.

Customer facing roles only:

While Novartis does not currently require a Covid-19 vaccination or proof of a recent negative test result for Covid-19, employees working in customer service roles must adhere to and adhere to customer policies (such as hospitals, doctor's offices, etc.). ). .) guidelines for accreditation, which may require vaccination. In accordance with applicable law, Novartis will consider requests for reasonable accommodations for those who cannot be vaccinated. This requirement is subject to applicable state and local laws and may not apply to employees working in certain jurisdictions. Send accommodation requests to[email protected].

Novartis Compensation and Benefits Summary: Starting salary for this position is expected to be between $136,800 and $205,200 per year; although the salary scales are in effect from 1.1.23. Up to and including 31-12-23, fluctuations in the labor market during this period may necessitate adjustments in the salary scale. In addition, the final salary determination will depend on a number of factors including, but not limited to, geographic location, level of experience, knowledge, skills and abilities. The total compensation package for this position may include other elements, including a sign-on bonus, limited equity and discretionary compensation, plus a full range of medical, financial and/or other benefits (including 401 eligibility). (k ) and various paid leave benefits, such as annual leave, sick leave, and paternity leave), depending on the position offered. Details of participation in these compensation plans will be provided when the employee receives a job offer. If hired, the employee will be in an "arbitrary position" and the company reserves the right to change base pay (as well as any other discretionary pay or compensation program) at any time, including for reasons related to individual performance . , Company or individual department/team performance and market factors.

What do you bring to the position:

Education: Bachelor degree required. Preference for advanced.

minimal iron

A minimum of three to five years of public or private third party reimbursement or pharmaceutical industry experience in managed care, clinical support or sales

Experience with specialty medicines purchased through networks of specialty pharmacies or specialty distributors (buying and billing)

Excellent knowledge of refund and billing methods

Experience working with established injection networks.

Experience with coding, billing and office support programs.

Previous account management experience or previous experience with complex accounts (payer landscape, large patient population, large systems)

Specialized pharmaceutical experience required (opportunity to teach the entire process from script to injection in the office)

Build relationships within the practice by working closely with them to remove barriers to reimbursement for specialty products for their patients.

Knowledge of Centers for Medicare & Medicaid Services (CMS) policies and processes with experience in Medicare Part B and D (medical and pharmacy benefit design and policies) a plus

Knowledge of managed care, state and federal payers, as well as integrated delivery network/integrated health systems is a plus

Ability to travel and cover large multi-state geographic areas, at least 50% travel required, based on geography and territory/destination composition; Must live within assigned territory

Puerto Rico only: Ability to communicate bilingually (Spanish and English) orally and in writing

Why Novartis?

Novartis medicines will have reached 766 million lives by 2021, and while we are proud of that, we know we can do much more to improve and extend people's lives.

We believe that new insights, perspectives and innovative solutions can be found at the intersection of medical science and digital innovation. Let a diverse, equitable and inclusive environment inspire new ways of working.

We believe our potential can thrive and grow in a bossless culture supported by integrity, curiosity and flexibility. And we can reinvent what's possible when we courageously work together to aggressively and ambitiously address the world's greatest medical challenges. Because the biggest risk in life is the risk of never trying!

Imagine what you can do here at Novartis!

Commitment to Diversity and Inclusion: Novartis is committed to creating an exceptional and inclusive work environment and diverse teams that represent the patients and communities we serve.

Accessibility and Reasonable Accommodations: Individuals who, due to a medical condition or disability, require reasonable accommodation for any part of the application process or to perform essential functions of the position, please email us at[email protected]or call +1(877)395-2339 and let us know the nature of your request and your contact details. Please include the application number in the message.

Join Our Novartis Network: If this role is not a good fit for your experience or career goals, but you want to stay connected to learn more about Novartis and our career opportunities, join the Novartis Network here:https://talentnetwork.novartis.com/network

Field Roles with Specific Training Period Only: The individual hired for this position must successfully complete specified initial training, including home study, of eight (8) hours or less per day and forty (40) hours or less per week.