Associate Director, Access & Reimbursement (ADAR) CV - Thousand Oaks, CA

Key Responsibilities:   

• Interact with large, complex accounts to support patient access within their aligned therapeutic area product(s), proactively provide face-to-face education on programs to providers and staff in order to support integration of those products into office processes and workflows. 

• Work with key members of therapeutic area offices (e.g., executives, providers, administrators, billing and coding staff, claims departments, revenue cycle managers) in order to appropriately support patient access to products. 

• Ability to analyze problems and offer solutions. Understand specifics and support questions associated with patient reimbursement and provide support on reimbursement issues with third party payers at the provider-level. Analyze account reimbursement issues (as needed). 

• Supports pull through on local coverage decisions to enable meaningful patient access within the system. Proactively communicate policy changes or issues that could potentially affect other departments. 

• Maintain expertise in regional and local access landscape, anticipating changes in the healthcare landscape, and act as their aligned therapeutic area product(s) reimbursement expert (as needed). 

• Interface with Patient Support Center (hub) and Access & Reimbursement Managers on important matters related to patient case management, including tracking cases, issue resolution, reimbursement support, and appropriate office staff education. 

• Collaborate with aligned cross-functional associates within NPC (see above) to share insights on customer needs and barriers for their aligned therapeutic area product(s) related to access and reimbursement. 

• Responsible for educating HCPs using approved materials regarding acquisition pathways for Novartis products. Educate on buy-and-bill end-to-end processes, workflows, and facility pull-through in complex accounts, including scenarios of centralized and decentralized acquisition, and use of alternative channels such as white bagging, clear bagging, brown bagging, and alternate site of care for administration. 

Buy and Bill Specific 

• Assess access situation within the assigned geography and develop appropriate Plan of Action (POA).  Communicate POA to appropriate personnel. 

• Responsible for educating HCPs using approved materials regarding acquisition pathways for Novartis products. Educate on buy-and-bill end-to-end processes, workflows, and facility pull-through in complex accounts, including scenarios of centralized and decentralized acquisition, and use of alternative channels such as white bagging, clear bagging, brown bagging, and alternate site of care for administration. 

• Educates relevant stakeholders on logistics related to ordering, payment, inventory, and product returns & replacement. 

• Analyze reimbursement issues, anticipating changes in the healthcare landscape, and act as the designated reimbursement expert for offices and field teams. 

• Accountable for engagement with non-prescribers in regards to Novartis medicines, for example pharmacy, system leadership, financial counselors, office administrators, revenue cycle managers, etc.   

• Education: Bachelor’s Degree required.  Business and/or biological science education preferred. Advanced degree preferred.   

• 5+ Years of experience in pharmaceuticals / biotech industry focused in Patient Services, Market Access, Sales, and/or account management. With 2 of those years being in a Patient Services practice support role for a specialty product(s). 

• Experience working with highly complex practices and/or health systems to establish access and acquisition pathways. 

• Strategic account management experience using a proactive approach to anticipate access hurdles impacting accounts and patient access. 

• Deep expertise and experience integrating manufacturer-sponsored patient support programs. 

• Experience with specialty products acquired through Specialty Pharmacy networks. 

• Knowledge of reimbursement pathways (specialty pharmacy, buy-and-bill, retail).  

• Candidate must reside within territory, or within a reasonable daily commuting distance of 60 miles from the territory border. Ability to travel 60-80% over a broad geography is required, with the ability to drive and/or fly within the territory. Must have a valid driver’s license.