Field Reimbursement Liaison

General Summary: The Field Reimbursement Liaison (FRL) provides access & reimbursement assistance to optimize the patient experience with assigned products.  The FRL is regionally based and coordinates a cross-functional team in ensuring patients have access to treatment. The FRL interfaces with healthcare professionals, including their ancillary staff, nurse case managers (NCMs), HUB coordinators, Market Access team, and various Channel Partners on complex access and reimbursement cases by providing education on company’s sponsored patient programs and process guidance in response to prior authorizations, resubmissions, and denials.  Candidates are strongly preferred to reside within assigned territory, to support timely and consistent engagement with healthcare providers, patient access stakeholders, and key accounts across this high priority territory. Essential Job Functions and Responsibilities:  These may include but are not limited to: Conduct office calls with HCPs and/or office staff for support with appropriate patient access to Company’s products, including assistance in resolving reimbursement, patient programs, and coverage questions. Resolve issues associated with patient coverage, access, and reimbursement in collaboration and coordination with patient services as directed by policy. Proactively communicate Company’s patient services programs, policies, procedures, and resources so that office staff (i.e., practice manager, nursing, billing, and reimbursement staff) are fluent in how to use our sponsored programs and systems. Liaise with Patient Support Center and our network Specialty Pharmacies. Provide strategic coverage/reimbursement leadership and support to the internal Sales team. Recommend and implement process improvement updates/changes to improve the patient experience. Serve as the subject matter expert on the reimbursement / access landscape, including payer policies, prior authorization requirements, denials, appeals, peer to peer, and other education required to navigate access. Provide insights and updates regarding product and support service integration at HCP and Hospital Pharmacy accounts. Conduct quarterly reviews with practices on their utilization of Companies patient services to better enhance our offerings to patients. Create training materials and deliver education programs to sales force, physicians, pharmacy directors, billing personnel, and other internal and external stakeholders as needed. Keep abreast of customer and market access industry trends; analyze access/reimbursement issues and opportunities.  Maintain a deep understanding of Companies policies and requirements and perform all responsibilities in a manner consistent with company guidance. Handle PHI appropriately.

Required: Bachelor’s degree required with a minimum of 12 years’ experience in healthcare and/or pharmaceutical/biotech industry. Clinical, technical, and scientific knowledge and aptitude in complex/rare diseases. Strong communication, organizational, and interpersonal skills (both written and verbal). Ability to gain high levels of credibility and excellent persuasion skills to achieve desired results. Knowledge of third-party payers (Medicare, Medicaid, commercial) and case management process (prior authorization and appeals). Demonstrated technical aptitude and working proficiency in using iPad and working proficiency in Microsoft Word, Excel, PowerPoint, and Outlook. Effective time management, resources allocation, and workload management. Comfort with ambiguity and the ability to adapt continuously. Demonstrated responsiveness and a sense of urgency. Ability to balance strategic thinking/analytical analysis with tactical execution. Functional and cross-functional teamwork experience. Ability to work independently. Must live within territory or within territory boundaries assigned for the position. Preferred: At least 3-5 years of access and