Field Reimbursement Manager (DC, VA, MD, WV)
New Jersey Permanent Posté le Dec. 17, 2024 Expire le Feb. 28, 2025Job title: Field Reimbursement Manager (DC, VA, MD, WV)
Location: Remote/Field
About the Job
The individual in this role will need to demonstrate a deep passion for patients and caregivers with an emphasis on enhancing and optimizing the patient and prescriber experience with our support program offerings. Moreover, since this is a foundational role, this individual will need to quickly establish compliant relationships with healthcare providers, helping to ensure successful access to the prescribed treatment.
The Tzield reimbursement environment is highly challenging for Health Care Providers (HCPs) and Patients. Payer medical and pharmacy Utilization Management (UM) criteria create process delays for patients such as required Benefits Investigations (BI), Prior Authorizations (PA), Denials, Appeals, detailed Clinical Documentation, and Peer to Peer reviews. Assisting HCPs and their patients to gain access to prescribed treatments requires dedicated and knowledgeable customer facing support. This support is provided by our FRM team. The FRM is a critical field-facing member of the Sanofi Patient Support Services organization and an integral part of the Tzield matrix team.
This is a regionally aligned, field-based position that provides reimbursement education and support for customers that utilize TZIELD (and other future products). The FRM will act at the subject matter expert on access, reimbursement, billing & coding processes and providing support through (1) product-specific provider reimbursement support, (2) coordination of HUB/Patients Services reimbursement services, and (3) managing payer/coverage pull-through initiatives. FRMs support the company and divisional reimbursement strategy. This position also requires the ability to successfully navigate working across multiple internal and external stakeholder teams, as well as program vendors, to deliver an exceptional experience.
We are an innovative global healthcare company, committed to transforming the lives of people with immune challenges, rare diseases and blood disorders, cancers, and neurological disorders. From R&D to sales, our talented teams work together, revolutionizing treatment, continually improving products, understanding unmet needs, and connecting communities. We chase the miracles of science every single day, pursuing progress to make a real impact on millions of patients around the world.
Main Responsibilities:
Will be subject matter expert on Sanofi patient support programs; payer policy, benefits and claim adjudication processes; billing & coding education; access issue resolution; financial assistance and alternative funding options provided by our patient support program.
Plan and implement geographic business plans to support appropriate access for Sanofi products.
Establish and maintain knowledge on the local and national payer landscape, including Specialty Pharmacy and Utilization Management criteria for assigned products
Monitor commercial, Medicare, and Medicaid communications on coverage, utilization management requirements, and coding & billing
Partner with internal matrix colleagues (sales, case management/navigators, medical, therapeutic education managers, market access, regional/national account directors) to collaborate, create a culture of respect, prioritization and customer focus
Work with specialty pharmacies and specialty distributors, as needed
Coordinate with different sites of care, including infusion centers
Assist HCPs with transition process from infusion site to home infusion, as appropriate
Establish relationships and serve as primary point of contact for healthcare provider offices within assigned region to work closely with and support HCPs/staff in resolving payer coverage issues that may be barriers to Sanofi product access in a manner that complies with all company policies and standard operating procedures.
Educate office personnel on appropriate billing guidelines including approved codes for approved uses, medical & pharmacy benefits, patient support program offerings.
Compliantly support HCPs/staff with the program enrollment process.
Communicate effectively with all internal/external partners & HCP customers
Ensure training is completed and demonstrate appropriate clinical knowledge of the respective product(s)
Record & report Adverse Events
Effectively triage product replacement requests
Backup colleagues and collaborate across patient services team(s)
Complete all company required compliance (and other) training in a timely manner
Complete all administrative duties in a timely and well-executed manner (expense reports, data entry into CRM system
Attend regional and national industry conferences, as allowed
About You
Basic Qualifications:
BA/BS Degree required, preferably in life science or business, MBA a plus
Minimum 10+ years' experience in the pharmaceutical or related healthcare industry
Minimum 5- 7 years pharmaceutical/biotech reimbursement or access experience in buy and bill setting, with demonstrated exceptional results
Excellent strategic thinking, analytical, and communication skills
Strong presentation skills
Must live within 30 miles of the assigned geography/region.
Demonstrated success of cross functional teamwork, leading without authority and working in a matrix environment (sales, market access, customer service, medical affairs, marketing, etc.)
Ability to travel to meetings/trainings/programs as necessary - additional travel will be required within the assigned geography.
Must achieve and maintain (at all times) compliance with all applicable Sanofi compliance policies, procedures, and legal requirements.
Valid driver's license
Preferred Qualifications:
Field Reimbursement, Market Access, or related experience
Physician and/or institutional reimbursement experience
Must be energetic and driven to succeed
Strong understanding and experience supporting infused (specialty) products, especially in the provider office, health care facility settings of care, and home infusion
Significant experience and understanding of the ever-changing payer environment and its impact on patient access to products infused in provider offices and health care facility settings of care.
Travel Requirements:
~50%-75% Travel, depending on geography
Candidates must complete all fleet safety training and must maintain an acceptable driving record regarding accidents and incidents.
Why Choose Us?
Bring the miracles of science to life alongside a supportive, future-focused team.
Discover endless opportunities to grow your talent and drive your career, whether it’s through a promotion or lateral move, at home or internationally.
Enjoy a thoughtful, well-crafted rewards package that recognizes your contribution and amplifies your impact.
Take good care of yourself and your family, with a wide range of health and wellbeing benefits including high-quality healthcare, prevention and wellness programs and at least 14 weeks’ gender-neutral parental leave.
This position is eligible for a company car through the Company’s FLEET program.
Candidates must complete all fleet safety training and must maintain an acceptable driving record regarding accidents and incidents.
The salary range for this position is $122,250.00 - $175,000.00 USD Annually. All compensation will be determined commensurate with demonstrated experience. Employees may be eligible to participate in Company employee benefit programs. Additional benefits information can be found through the link, www.benefits.sanofiusallwell.com
Sanofi Inc. and its U.S. affiliates are Equal Opportunity and Affirmative Action employers committed to a culturally diverse workforce. All qualified applicants will receive consideration for employment without regard to race; color; creed; religion; national origin; age; ancestry; nationality; marital, domestic partnership or civil union status; sex, gender, gender identity or expression; affectional or sexual orientation; disability; veteran or military status or liability for military status; domestic violence victim status; atypical cellular or blood trait; genetic information (including the refusal to submit to genetic testing) or any other characteristic protected by law.
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