Market Access Field Reimbursement Manager

Description

ADMA Biologics is a biopharmaceutical company relentlessly committed to creating superior products for immunodeficient patients at risk for infection. It is our devotion to this underserved population that fuels us and our hands-on approach to production and development that sets us apart.  If you are looking for a dynamic, innovative, growing company in the biopharmaceutical industry that is committed to excellence and integrity, then consider ADMA Biologics. We currently have an exciting opportunity available for a Manager of Market Access, Reimbursement & National Accounts - Central Region!

The Market Access Field Reimbursement Manager (FRM) - Central Region will proactively engage with the ADMA field force to provide education and support to providers and their offices/staff on ADMA HUB Patient Support Program and services, current national and regional payor coverage, and payor policy for regionally and nationally based customers. This role serves as the key contact for field-based reimbursement and access support-related matters and is responsible for being the local market access expert on payer, policy, and processes to help partners navigate coverage and help support patients.

ESSENTIALS OF THE JOB:

• Provide clear and detailed coverage, criteria and policy education to healthcare provider offices, physician owned infusion suites, ambulatory infusion suites, National and Regional Specialty pharmacies/Home Infusion providers and hospital-based outpatient infusion centers.
• The (FRM) will work with the ADvantage Ig Patient Support Program (HUB) to help ensure clear and transparent communication between providers and ADMA.
• Communicate technical knowledge of patient enrollment, prior authorizations, appeals, and ADMA Biologics sponsored HUB support programs.
• Serve as the market access training lead for respective territory, delivering policy updates and program information as needed.
• Collaborate in cross-functional meetings with Sales, Market access, and Medical Affairs as needed to help support providers.
• Maintain compliance with PHI/HIPAA and company policies.
• This role will cover the Central region and will be responsible for the central United States, as well as covering additional regions as needed.
• This is a remote role and travel within your region and national meeting will be approximately (60-75%).
• Ideally, this candidate will live in the Ohio Valley region or surrounding area.

Qualifications

Education Requirements:

• Bachelor’s degree required, preferably in life science or business, master’s degree a plus. (RN is a plus)

Experience Requirements:

• 10 years of experience working for a major pharmaceutical organization on the field reimbursement team, understanding different site of care provider segments and payors, i.e., (Commercial, Medicare, Medicaid, VA/DOD/Tricare, and ACA) as well as a deep understanding of the Medical and Pharmacy benefits, billing and coding practices for infused products is required.
• Extensive frontline experience working with and across the various infusion service areas within the US health care system. Specifically, Physician Buy and Bill offices, Ambulatory Infusion suites, National and Regional Specialty Pharmacies/Home Infusion Providers and hospital owned outpatient infusion centers.
• Must be able to understand and clearly disseminate payor policy and criteria for coverage in the medical and pharmacy benefit to existing and future providers.
• Must be able to think independently, analyze issues and make recommendations that will help providers and patients obtain coverage to start therapy.
• Must have extensive Buy and Bill experience in Rare Disease, Plasma/IVIG, Oncology or Orphan Disease.
• Ability to work independently and make decisions, but with the knowledge of the situations where supervisory input is essential.
• Strong understanding of healthcare regulatory and enforcement environments along with demonstrated integrity on the job.
• Employees are responsible for ensuring compliance with all ADMA Quality policies, standards, and SOPs in their area of work and responsibility. This includes ensuring all Quality Assurance (QA) records and reports, Human Resources (HR) policies, and Environmental Health and Safety (EH&S) procedures and practices are completed in a timely manner.
• Ability to work cross-functionally in a highly dynamic environment with a high sense of urgency.
• Must be Proficient in Microsoft Office, Excel, and PowerPoint and Teams.
• Excellent written and verbal communication skills.

In addition to competitive compensation, we offer a comprehensive benefits package including:

• 401K plan with employer match and immediate vesting

• Medical, Vision, Life and Dental Insurance

• Pet Insurance 

• Company paid STD and LTD

• Company Paid Holidays 

• 3 Weeks’ Paid Time Off (within the first year)

• Tuition Assistance (after the first year)

• Easily accessible to Tri-Rail

• Free Shuttle to the Boca Tri-Rail station

ADMA Biologics uses E-Verify to confirm the employment eligibility of all newly hired employees. To learn more about E-Verify, including your rights and responsibilities, please visit www.dhs.gov/E-Verify. 

ADMA Biologics is an Equal Opportunity Employer.