Field Reimbursement Senior Manager - North East
Field Reimbursement Senior Manager - North East
United States - Massachusetts - Boston
Gilead Sciences, Inc. is a research-based bio-pharmaceutical company that discovers, develops and commercializes innovative medicines in areas of unmet medical need. With each new discovery and investigational drug candidate, we seek to improve the care of patients living with life-threatening diseases around the world. Gilead's therapeutic areas of focus include HIV/AIDS, liver diseases, cancer and inflammation, and serious respiratory and cardiovascular conditions.
Making an impact on a global scale
Inclusion is one of the company's five core values. That's because we know that we are stronger and more innovative at Gilead when we are informed by a diverse set of backgrounds, experiences and points of view. Gilead Sciences is a biopharmaceutical company that discovers, develops and commercializes innovative therapeutics in areas of unmet medical need. The company's mission is to advance the care of patients suffering from life-threatening diseases worldwide.
When you join Gilead, you join our mission to change the world by enabling people to live healthier and more fulfilling lives. Come join a mission-driven bio-pharmaceutical organization that values inclusion and diversity, has a strong portfolio of products, and is constantly #CreatingPossible
The Field Reimbursement Senior Manager (FRSM) will work as a field-based patient access specialist in an assigned region that provides appropriate reimbursement support to providers and professional staff to help facilitate access to Gilead Sciences' Oncology products once a prescribing decision has been made.
The FRSM will leverage in depth expertise in reimbursement, payer coverage, patient assistance, and healthcare policy to educate offices to help minimize barriers to patient access.
Territory Covered: Massachusetts, New York, New Jersey, Pennsylvania, Connecticut, Vermont, Maine, New Hampshire, Rhode Island
The primary purpose of this role is to provide information and education to support patients in obtaining appropriate access to Gilead Oncology products. This position provides education of patient affordability offerings as well as an understanding of the patient support programs offered at Gilead Oncology. FRSMs support the company reimbursement strategy and this position requires the ability to successfully navigate working across multiple internal and external stakeholders and program vendors to deliver expeditious access to an important therapy.
Responsibilities and Duties:
- Support oncology HCPs and staff in resolving reimbursement issues / barriers through the provision of relevant information in compliance with Gilead Sciences' policies, processes and guidelines.
- Support the oncology HCP offices as a resource for up-to-date regional reimbursement information relating to Gilead Oncology products.
- Engage sites of care to inform them on matters related to access and reimbursement of Gilead Oncology products.
- Conduct meetings as needed with key office staff to learn about patient reimbursement challenges and educate them on Gilead Sciences' reimbursement and patient support including coding information for approved uses, medical & pharmacy benefit information, and patient support program offerings.
- Has and maintains expertise in regional and national payer landscapes with expertise in reimbursement policy, utilization management criteria, prior authorization processes and appeal requirements.
- Monitor commercial, Medicare and Medicaid communications on coverage, coding and payment.
- Partner with colleagues to create a culture of respect and focus on product launches.
- Develop ongoing interaction with customers in a manner that anticipates and adapts to their reimbursement information needs as well as market changes / challenges.
- Demonstrate extensive knowledge of specialty payer landscape, the appropriate utilization of NCCN / ASCO guidelines, private payer, GPOs, Medicare and Medicaid structure, Specialty Pharmacy systems and reimbursement processes and the general evolution of the healthcare landscape.
- Partner with Gilead sales and market access teams, as appropriate, to advance patient access strategies.
- Collaborate with internal cross-functional partners, as appropriate, to help ensure optimal knowledge of coverage
- When appropriate, provide strategic coverage / reimbursement leadership and support to Field Sales Leadership to which their geographies align.
- Follow the highest level of professional and compliance standards in all interactions with customers and other business contacts.
- Adhere to Gilead's business conduct policies and other relevant SOPs and guidance.
- Able to travel extensively within the region (estimated 40% overnight).
- This territory currently covers the following states:
Background and Experience:
- Bachelor's degree
- 10 years' experience in the pharmaceutical / biotech or related healthcare industry
- 5 years' experience with Specialty Pharmaceuticals / Biologics
- Significant expertise in market access and reimbursement matters
- Advanced experience in reimbursement of oncology related injectables (Buy and Bill)
- Ensure strong understanding and utilization of Specialty Pharmacy and third-party services.
- In depth knowledge of pharmaceutical manufacturer compliance, patient confidentiality, product reimbursement and product access requirements.
- Knowledge of regulations and laws governing the protection of patient identifying information, and relevant laws, regulations, and policies pertaining to access offerings.
- Knowledge of Medicaid and Medicare policies, procedures and processes with expertise in Part B & D (Medical / Pharmacy Benefit design and coverage policy)
- Strong strategic account management planning skills
- Valid driver's license
- Advanced interpersonal and communication skills.
- Superior presentation skills
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As an equal opportunity employer, Gilead Sciences Inc. is committed to a diverse workforce. Employment decisions regarding recruitment and selection will be made without discrimination based on race, color, religion, national origin, gender, age, sexual orientation, physical or mental disability, genetic information or characteristic, gender identity and expression, veteran status, or other non-job related characteristics or other prohibited grounds specified in applicable federal, state and local laws. In order to ensure reasonable accommodation for individuals protected by Section 503 of the Rehabilitation Act of 1973, the Vietnam Era Veterans' Readjustment Act of 1974, and Title I of the Americans with Disabilities Act of 1990, applicants who require accommodation in the job application process may contact email@example.com for assistance.
For more information about equal employment opportunity protections, please view the 'EEO is the Law' poster.
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