Senior Manager, Access Reimbursement Management - Ohio/Upstate NY & Pennsylvania

General Scope and Summary

Sage Therapeutics is currently recruiting for a Senior Manager, Access Reimbursement Management to join their National Access Reimbursement Manager (ARM) team within the Market Access field organization.

The Senior Manager, Access Reimbursement Management will provide education, assistance, and issue resolution with healthcare providers (HCPs) and their office staff for patient access to Sage in-line products. Outreach may be telephonic as well as in-person. Stakeholders include HCPs and office staff that are writing prescriptions for in-line Sage products, other healthcare settings utilizing Sage products, Sage Sales colleagues (TBMs, RBDs, ABDs), Patient Support Navigators, National Account Directors, Regional Account Directors, Specialty Pharmacies, and Payers (Health Plans and PBMs).

Roles and Responsibilities

• Equip HCPs and their staff, through education, to navigate the patient-level payer access requirements and approval process for zuranolone (upon FDA approval) within a specified geographic region.

• Demonstrate an advanced understanding of public and private payers, how to research to determine specific coverage barriers, and how to communicate effectively to internal stakeholders and external HCPs regarding education on Medicaid (FFS and Managed Care), commercial plans, PBM designs, policy changes, and formulary status.

• Demonstrate knowledge of pharmacy benefit reimbursement practices, compliance, billing and coding processes, and utilization management/prior authorization process.

• Confidently reference reimbursement and access materials to educate HCPs on access related questions.

• Embrace Sages culture of compliance and ensure that all activities are fully compliant with Sage policies and procedures, applicable laws, regulations, and industry standards; align all activities with Our Values, including putting patients and their families first.

• Implement and support the strategic tactical plan for the execution of product access and reimbursement through partnership with internal and external stakeholders.

• Understand key stakeholders within an HCP office and how to navigate relationships in a manner that anticipates and adapts to customer reimbursement support needs and any market access challenges.

Experience, Education and Specialized Knowledge and Skills

Must thrive working in a fast-paced, innovative environment while remaining flexible, proactive, resourceful, and efficient. Must have excellent interpersonal skills, the ability to develop important relationships with key stakeholders, good conflict management and negotiation skills, and the ability to analyze complex issues. Must have a demonstrated ability to analyze complex situations and communicate a path forward in a simple, streamlined manner.

Basic Qualifications

• Bachelors degree required.

• 5+ years of experience, including 3+ years of experience in payer marketing, patient support programs, or field reimbursement support.

Preferred Qualifications

• Ability to travel up to 30% for key meetings and customer relationships required.

• Must be located within 50 miles of a major airport in or near the territory.

• Understanding of the healthcare environment specifically around delivering services to Health Care Professionals and Patient customers.

• Understanding of specialty pharmacies, managed care, medical and pharmacy benefit, andgovernment payers and their impact on product access.

• Ability to communicate payer coverage criteria, payer policy, and prior approval processes.

• Ability to manage multiple internal touch points and effectively prioritize the support of field service requests within a large geographical region.

• Experience navigating through complex access challenges specific to specialty pharmacy in multiple regions/states.

• Understanding of national and state legislative, Medicare, Medicaid, and private payer and pharmacy coverage initiatives affecting reimbursement of pharmaceutical and biotechnology products.

• Compliance with all Sage corporate policies, internal procedures and training, and applicable laws and industry codes in collaboration with Sages Legal, Regulatory, and Compliance teams.

• Results oriented, self-organized, and self-starter with a proven track record of results.

• Possess strong critical thinking, problem solving, and analytical skills with high attention to detail.

• Possesses strong written and verbal communication skills.

• Desire to innovate and work in a fast-paced, energetic environment with competing priorities.

• Valid drivers license.

• Specialty pharmacy reimbursement experience.

• Embrace our core values: Put People First, Improve Lives, Cultivate Curiosity, Do Right, and Forge New Pathways.

• Excitement about the vision and mission of Sage.

• The actual salary offered within the range is dependent on a variety of factors including, but not limited to, relevant experience, qualifications, education, skills, and performance.
• This position is eligible to participate in the Companys annual bonus plan; the bonus varies based on performance and is subject to the standard terms and conditions of the incentive program.
• To support your well-being, we offer a comprehensive benefits and wellness package, which includes medical, dental, and vision coverage upon hire. More information can be found in our Benefits Guide.