AD, Access & Reimbursement RLT - Los Angeles, CA

Key Responsibilities:

• Interact with large complex accounts to support patient access within their aligned therapeutic area product(s) proactively provide face-to-face education on programs to providers and staff in order to support integration of those products into office processes and workflows.
• Address customer questions for issues related to NPC policies on therapeutic area products ordering payment inventorying and product returns & replacement in offices.
• Work with key members of therapeutic area offices (e.g. executives providers administrators billing and coding staff claims departments revenue cycle managers) in order to appropriately support patient access to products.
• Ability to analyze problems and offer solutions. Understand specifics and support questions associated with patient reimbursement and provide support on reimbursement issues with third party payers at the provider-level. Analyze account reimbursement issues (as needed). Identifies trends at a local regional and national level and partner with purpose internally and externally to support patient access to Novartis medicines
• Supports pull through on local coverage decisions to enable meaningful patient access within the system. Proactively communicate policy changes or issues that could potentially affect other departments.
• Accountable for informing customers on NVS-sponsored patient support programs to help enable patients starting and staying on therapy (i.e. Co-pay).
• Maintain expertise in regional and local access landscape anticipating changes in the healthcare landscape and act as their aligned therapeutic area product(s) reimbursement expert (as needed).
• Interface with Patient Support Center (hub) and Access & Reimbursement Managers on important matters related to patient case management including tracking cases issue resolution reimbursement support and appropriate office staff education.
• Collaborate with aligned cross-functional associates within NPC (see above) to share insights on customer needs and barriers for their aligned therapeutic area product(s) related to access and reimbursement.
• Maintain a deep understanding of NPC policies and requirements and perform all responsibilities with integrity and in a manner consistent with company guidance and prescribed Values and Behaviors. Handle Patient Identifiable Information (PII) appropriately (understand and ensure compliance with HIPAA and other privacy laws and regulations and internal Company compliance guidelines).
• Responsible for identifying and reporting adverse events via the established Novartis systems as per applicable processes.

Buy and Bill Specific

• Assess access situation within the assigned geography and develop appropriate Plan of Action (POA). Communicate POA to appropriate personnel.
• Responsible for educating HCPs using approved materials regarding acquisition pathways for Novartis products. Educate on buy-and-bill end-to-end processes workflows and facility pull-through in complex accounts including scenarios of centralized and decentralized acquisition and use of alternative channels such as white bagging clear bagging brown bagging and alternate site of care for administration.
• Educates relevant stakeholders on logistics related to ordering payment inventory and product returns & replacement.
• Analyze reimbursement issues anticipating changes in the healthcare landscape and act as the designated reimbursement expert for offices and field teams.
• Accountable for engagement with non-prescribers in regard to Novartis medicines for example pharmacy system leadership financial counselors office administrators revenue cycle managers etc.

Radioligand Therapies Specific

The ADAR will be a critical partner to the Novartis Patient Support (NPS) customer engagement team on supply capacity site procurement eligibility as well as a customer facing resource for communications on orders and logistics.

• Understand RLT key priorities in core disease areas financial goals and site initiatives to influence overall account and regional business strategies.
• Assess and understand site and/or other appropriate organizations level of readiness for procurement of nuclear medicines and billing to facilitate orders for products and so that they can engage and educate on procurement systems and processes access and reimbursement. Be able to understand where gaps in procurement exist and work with Cross-Functional partners to resolve.
• Partner with the customer engagement teams to assist the communication and facilitation of procurement and logistics with both the site and the local field teams. (e.g. procurement logistics processes and timing and education regarding available rebate offerings as appropriate) as well as patient-specific support (benefit verification PA appeals copay programs and applicable rebate offerings)
• Partner with Market Access to support follow up to help ensure completion of purchase agreements & GPO forms by acting as liaison for RLT Access Lead (RAL) for new site onboarding.
• Responsible for supporting treatment site onboarding to include RAM license W9 & PRD preferences
• Major accountabilities apply to therapy diagnostic and theragnostic treatment centers.

What Youll Bring to the Role:

Education: Bachelors degree required; Business and/or biological science education preferred. Advanced degree preferred.

Essential Requirements:

• 5 Years of experience in pharmaceuticals / biotech industry focused in Patient Services Market Access Sales and/or account management. With 2 of those years being in a Patient Services practice support role for a specialty product(s).
• Experience working with highly complex practices and/or health systems to establish access and acquisition pathways.
• Strategic account management experience using a proactive approach to anticipate access hurdles impacting accounts and patient access.
• Deep expertise and experience integrating manufacturer-sponsored patient support programs.
• Experience with specialty products acquired through Specialty Pharmacy networks
• Knowledge of reimbursement pathways (specialty pharmacy buy-and-bill retail)
• Possess a strong understanding of Commercial payers Medicare plans and state Medicaid in geographic region.
• Must live within assigned territory.
• Ability to travel and cover geography at least 50% travel required based on geography and territory / targeting make up.
• Driving is an essential function of this role meaning it is fundamental to the purpose of this job and cannot be eliminated.
• Because driving is an essential function of the role you must have a fully valid and unrestricted drivers license to be qualified for this role.
• The company provides reasonable accommodations for otherwise qualified individuals with medical restrictions if an accommodation can be provided without eliminating the essential function of driving.

Desirable Requirements:

• Experience leading and delivering presentations to C-level account executives.
• Strong ability to work cross functionally with such functions as Field Sales Marketing Market Access Public Affairs State & Government Affairs Trade Specialty Pharmacy Account Management and applicable third-party affiliates.
• Expertise in therapeutic area practice dynamics and common reimbursement and product program support-related needs.
• Strong capabilities in the areas of customer focus collaboration business acumen communication and presentation skills.
• This position requires significant use of a company provided vehicle and maintaining good driving record
• This is a field-based customer engaging position
• Control business expenses related to field activities (i.e. travel customer meetings) and provide timely expense reports to manager.

Novartis Compensation and Benefit Summary: The pay range for this position at commencement of employment is expected to be between $160300.00 and $297700.00/year; however while salary ranges are effective from 1/1/25 through 12/31/25 fluctuations in the job market may necessitate adjustments to pay ranges during this period. Further final pay determinations will depend on various factors including but not limited to geographical location experience level knowledge skills and abilities. The total compensation package for this position may also include other elements including a sign-on bonus restricted stock units and discretionary awards in addition to a full range of medical financial and/or other benefits (including 401(k) eligibility and various paid time off benefits such as vacation sick time and parental leave) dependent on the position offered. Details of participation in these benefit plans will be provided if an employee receives an offer of employment. If hired employee will be in an at-will position and the Company reserves the right to modify base salary (as well as any other discretionary payment or compensation program) at any time including for reasons related to individual performance Company or individual department/team performance and market factors.

Field roles with a dedicated training period only:

The individual hired for this role will be required to successfully complete certain initial training including home study in eight (8) or fewer hours per day and forty (40) or fewer hours per week.

Driving is an essential function of this role meaning it is fundamental to the purpose of this job and cannot be eliminated. Because driving is an essential function of the role you must have a fully valid and unrestricted drivers license to be qualified for this role. The company provides reasonable accommodations for otherwise qualified individuals with medical restrictions if an accommodation can be provided without eliminating the essential function of driving.