Key Responsibilities: Act as a compliant subject matter expert (SME) in reimbursement, access, and specialty distribution for assigned geography. Provide education to HCP offices on coverage status, prior authorization processes, appeals, and alternate funding options for uninsured/underinsured patients. Build and maintain productive relationships with HCPs, office staff, and health system stakeholders. Analyze regional/local payer coverage trends, reimbursement criteria, and payer mix. Provide guidance on specialty pharmacy services and help customers navigate complex distribution channels. Partner with Patient Support to ensure accurate benefit investigations and streamlined patient onboarding. Collaborate with internal partners to build local access strategies aligned with business objectives. Develop and execute territory-level business plans using strategic customer insights. Participate in field-based problem-solving, including reimbursement issue resolution and case escalation when needed. Identify process improvements to enhance patient access and provider satisfaction. Maintain compliance with legal/regulatory/company policies, including patient privacy and promotional conduct. Requirements: Bachelor's degree in an allied health field preferred or equivalent work experience. 8+ years in pharma/biotech/related healthcare industry. Prior reimbursement experience required: substantial experience with prior authorizations and navigating the US payer landscape. 3-6 years supporting Specialty Pharmaceuticals/Biologics. Deep understanding of reimbursement, access, and specialty pharmacy operations. Experience supporting product launches or guiding patients through insurance approval processes. Strong understanding of Specialty Pharmacy distribution models and patient services programs. Knowledge of HIPAA and other federal/state laws governing patient confidentiality and healthcare communications. Bilingual skills (English/Spanish) highly desired. Proven track record supporting complex therapies in rare or specialty conditions. Exceptional communication/interpersonal skills; builds trust with providers and internal partners. Comfortable with ambiguity and managing multiple cases in real time. Digital fluency with CRM platforms; comfortable educating patients on technology-enabled tools, including AI-based platforms. Benefits: 401(k) with company match; comprehensive medical/dental/vision; company-paid Life and AD&D; company-paid short/long-term disability; voluntary Pet and Legal Insurance; EAP; employee discounts and professional development; HSA and FSA; accident/critical illness/hospital indemnity; paid parental leave and mental health resources; performance-based incentive compensation. Compensation: Annual base salary: $185,000-$190,000. #J-18808-Ljbffr
...ordering process. Offer appropriate alternatives that meet customer needs. Ensure accuracy of customer information and ensure data entry into company ERP is correct. Partner with Drivers and Outside Sales to ensure customer requirements are met in a timely fashion...
...focused on making a positive impact on the lives of residents, their families and team members.We are looking for a Director of Health and Wellness to join our amazing team!ResponsibilitiesParticipates in pre-admission screening of prospective new residents. Assures that...
...We are seeking a highly skilled and compassionate Registered Nurse to join our team. As a Registered Nurse, you will play a... ...medications/treatments as ordered by provider and complete prior authorizations for medication and diagnostic services Maintain safe, secure...
...Job Title: RPA Lead/ UiPath Engineer Location: Cupertino, CA (Onsite- 5 days a week) Hire Type: Fulltime and Contract (long-term) Key Responsibilities: Analysis & Design: Work with business analysts to understand processes, identify automation...
...Job Description Job Description Job Title: Payroll Tax Consultant Job Description The Payroll Tax Consultant plays a key role in ensuring accurate, compliant, and timely payroll tax processing across a complex multi-entity environment. This position focuses...