Reimbursement Business Manager, San Diego, CA

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Reimbursement Business Manager, Immunology - San Diego, CA - South

Position Summary: 

The Field Access & Reimbursement environment for specialty biologics has proven to be highly challenging for HCPs and Patients.  Payer Formularies and restrictive Utilization Management Criteria including:  Prior Authorization Processes, Step Edits, Appeals, detailed Clinical Documentation, Peer to Peer reviews etc. requires dedicated and focused customer facing support through the Reimbursement Management Team.

The Reimbursement Business Manager (RBM) is a critical front-line member of the Regeneron Commercial and Field Reimbursement Management team. The primary purpose of this role is to support Health Care Practitioner offices in obtaining appropriate access to Regeneron products for patients.   Ensuring optimal access, effective pull-through, and understanding of access services and program support as it relates to the Regeneron Alliance product portfolio.  Support the company and divisional reimbursement strategy for Regeneron products within various payer segments.  The RBM position requires the ability to successfully navigate and across multiple internal stakeholders, sales teams, Payer teams, Alliance partners, HUBs, etc.  The Field Access Specialist reports to the District Manager of Field Market Access. 

Regeneron has an Alliance partner for commercializing Dupixent.  As a result, members of the Regeneron Field Reimbursement Team must demonstrate the ability to in a proactive and highly collaboratively environment across an Alliance team.    

Essential Duties/Responsibilities:

• Work cross-functionally and collaboratively with Regeneron and Alliance sales organizations (Sales Directors and Medical Specialists) to act as a process and payer subject matter expert, in efforts to support the healthcare provider segment.
  • Execute a Strategic tactical plan for the execution of Alliance products access and reimbursement initiatives relevant to the defined needs of each respective product and account within the defined customer market
• Execute against established performance parameters and monitor personal performance against these agreed parameters:
  • Work closely with REGN, Sanofi and Sanofi-Genzyme partners as assigned; REGN, Sanofi and Sanofi-Genzyme District Sales Managers, Medical Specialists, other RBM, Reimbursement, Marketing and Access team members in assigned geographical areas to insure optimal coverage and customer knowledge of this process and all REGN patient services within defined accounts
• Provide appropriate process, payer and specialty pharmacy support services/activities in concert with District Managers/Medical Specialists (field sales), to educate physician offices regarding coverage of alliance products, in efforts to streamline the coverage and specialty pharmacy processes to obtain alliance products
• Establish and maintain knowledge on the local and national payer landscape, including Specialty Pharmacy and Utilization Management criteria for assigned products
• Establish relationships within targeted healthcare provider offices to assist healthcare professionals in resolving payer coverage issues that may be barriers to Alliance product access in a manner that complies with Regeneron policies, processes, and standard operating procedures
• Maintain knowledge base necessary to ensure support of all access and patient/payer support programs and resources offered for all products.

• Assist in providing appropriate field insights  throughout  the development of  Market Access  marketing  support materials as needed
• Ensure individual training and knowledge is maintained to the level required to guarantee that personnel are seen as the most knowledgeable team in the industry as it pertains to access and reimbursement across Alliance therapeutic areas as well as future product markets
• Ensure training is completed and kept up-to-date with appropriate clinical knowledge of the respective products
• Develop and execute annual budget with allocation within respective territory

Education and Experience:

• Minimal educational requirement: Bachelor’s Degree

• Minimum 5 years’ experience in pharmaceuticals and/or sub-cutaneous self-injectable biologics working in a matrix environment – with 2 years Reimbursement experience
• Experience working with products delivered through a Specialty Pharmacy network is critical
• Reimbursement experience a plus
• Experience in self injectable biologic products a plus
• Strong collaboration and proactive communication skills required
• Background in leadership and effective cross functional teamwork a plus
• Established ability to work within an Account Management based structure
• Demonstrate excellent interpersonal and collaboration skills

Knowledge, Skills and Abilities:

• Knowledge of CMS policies and processes with expertise in Part D (Pharmacy Benefit design and coverage policy)
• Attention to details, Time Management (multi-tasking) and Problem-Solving skills are required
• Demonstrate excellent interpersonal, leadership and coaching skills within a matrix team environment
• Strong strategic planning skills
• Strong interpersonal skills
• Knowledge of Commercial Insurers, Managed Care, Government, and Federal payer sectors
• Knowledge of Integrated Delivery Network/Integrated Health Systems
• Excellent verbal and written communication skills
• Ability to rapidly assimilate information in a fast-paced environment
• Ability to develop and maximize relationships
• Previous experience in launching new Specialty Pharmaceutical/ Biologics products or indications

Explore Location: Geography includes San Diego, CA South