AD, Access & Reimbursement, CV San Jose, CA

Band

Level 5

Job Description Summary

#LI-Remote

The Associate Director Access & Reimbursement NPS (Novartis Patient Support) Cardiovascular San Jose CA is a remote & field-based role that covers the following but not limited to: Fresno Salinas Stockton Tracy Clovis San Mateo Palo Alto & San Jose CA. Associate must reside within territory or within a reasonable daily commuting distance of 60 miles from territory border.


The Associate Director Access & Reimbursement (ADAR) is a field-based role that proactively provides in person (or virtual as needed) education to defined accounts within their assigned geographies on a wide range of access and reimbursement topics and needs (see below) in support of aligned product(s) strategy. ADARs primarily focus on accounts with increased process and workflow complexity typically including centralized and decentralized systems of care integrated delivery networks academic medical institutions large multi-provider specialty practices and alternate sites of care.

ADARs will serve as the patient access and reimbursement lead in business-to-business conversations with account executives. The ADAR role is responsible for managing the pull-through of access and reimbursement strategy and downstream operations within their aligned accounts. ADARs are expected to have deep expertise in communicating requirements and addressing barriers associated with local payer policy coverage multi-channel acquisition pathways billing and coding education (as needed) claims processing reimbursement and integration of manufacturer support programs into a range of account workflows. ADAR will continually need to demonstrate a keen ability to problem solve and manage multiple projects.

ADARs partner closely with other Novartis Pharmaceuticals Corporation (NPC) field associates including Customer Engagement (Sales) and Market Access representing NPC with the highest integrity in accordance with NPC Values and Behaviors. ADARs will also be required to coordinate and communicate cross-functionally within NPC (e.g. Patient Support Center Customer Engagement Marketing Market Access Public Affairs State & Government Affairs Trade Specialty Pharmacy Account Management and other applicable third party affiliates).

Job Description

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 regards to Novartis medicines for example pharmacy system leadership financial counselors office administrators revenue cycle managers etc.

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.

Compensation Summary:

The salary for this position is expected to range between $160300 and $297700 per year. The final salary offered is determined based on factors like but not limited to relevant skills and experience and upon joining Novartis will be reviewed periodically. Novartis may change the published salary range based on company and market factors. Your compensation will include a performance-based cash incentive and depending on the level of the role eligibility to be considered for annual equity -based eligible employees will receive a comprehensive benefits package that includes health life and disability benefits a 401(k) with company contribution and match and a variety of other addition employees are eligible for a generous time off package including vacation personal days holidays and other leaves.

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.

COVID-19 Vaccine Policy (customer-facing roles only): While Novartis does not require vaccination for COVID-19 or proof of a recent negative test result for COVID-19 at this time employees working in customer-facing roles must adhere to and comply with customers (such as hospitals physician offices etc.) credentialing guidelines which may require vaccination. As required by applicable law Novartis will consider requests for reasonable accommodation for those unable to be vaccinated. This requirement is subject to applicable state and local laws and may not be applicable to employees working in certain jurisdictions. Please send accommodation requests to

For Field Roles with a Dedicated Training Period:

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

EEO Statement:

The Novartis Group of Companies are Equal Opportunity Employers. We do not discriminate in recruitment hiring training promotion or other employment practices for reasons of race color religion gender national origin age sexual orientation gender identity or expression marital or veteran status disability or any other legally protected status. We strive to create an inclusive workplace that cultivates bold innovation through collaboration and empowers our people to unleash their full potential.

Accessibility and reasonable accommodations

The Novartis Group of Companies are committed to working with and providing reasonable accommodation to individuals with disabilities. If because of a medical condition or disability you need a reasonable accommodation for any part of the application process or in order to perform the essential functions of a position please send an e-mail to call 1 and let us know the nature of your request and your contact information. Please include the job requisition number in your message.

Range

$160300.00 - $297700.00

Skills Desired

Access And Reimbursement Strategy Agility Analytical Skill Analytical Thinking Cross-Functional Collaboration Customer-Centric Mindset Employee Development Finance Go-To-Market Strategy Healthcare Sector Understanding Health Economics Health Policy Health Technology Assessment (HTA) Innovation Inspirational Leadership Market Access Strategy Negotiation Skills People Management Process Management Public Affairs Real World Evidence (RWE) Regulatory Compliance Risk Management Value Propositions Waterfall Model