Access & Reimbursement Manager, Cardiovascular - IL & St Louis MO Territory - Remote

Summary

Access and Reimbursement Manager (ARM) is a field-based role that proactively provides in person (or virtual as needed) education to defined accounts within their assigned geographies on a wide range of access and reimbursement topics and needs in support of aligned product(s) strategy. ARM will serve as the key contact and lead for access and reimbursement support‑related matters and is responsible for being the local market access expert on payer policy coverage, multi‑channel acquisition pathways, billing and coding, claims processing, reimbursement, and integration of manufacturer support programs into a range of account workflows.

Additionally, the ARM will continually need to demonstrate a keen ability to problem solve, analyze access and reimbursement issues and opportunities, and proactively communicate changes in the healthcare landscape. ARM will partner closely with other Novartis Pharmaceuticals Corporation field associates, including Customer Engagement (Sales) and Market Access, representing NPC with the highest integrity in accordance with NPC Values and Behaviors.

ARM will also be required to coordinate and communicate cross‑functionally within NPC (e.g., Patient Support Center, Customer Engagement, Marketing, Market Access, Public Affairs, State & Government Affairs, Trade, Specialty Pharmacy Account Management, and other applicable third‑party affiliates). This is a remote and field‑based role that covers, but is not limited to, the following locations in the St. Louis, MO territory:

• Springfield, IL
• Peoria, IL
• Champagne, IL
• Bloomington, IL
• St. Louis, MO

• Interact within assigned accounts to support patient access within their therapeutic area product(s) providing proactive face‑to‑face education on product‑specific programs to providers and staff in order to support integration of those programs into office processes and workflows.
• Address customer questions for issues related to NPC policies on therapeutic area product ordering, payment, inventorying, and product returns & replacement in offices.
• Work with key members of therapeutic area offices (e.g., providers, administrators, billing and coding staff, claims departments, revenue cycle managers) in order to appropriately support patient access to products.
• Analyze problems, offer solutions, and support questions related to payer policies, drug acquisition, inventory management and patient / practice reimbursement. Analyze account reimbursement issues & opportunities (as needed). Identify trends at a local, regional and national level and partner with purpose internally and externally.
• 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.
• Accountable for standing up NVS‑sponsored patient support programs to enable patients starting and staying on therapy (i.e., Co‑pay).
• 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.
• Interface with Patient Support Center (hub) 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 to share insights on customer needs and barriers for their aligned therapeutic area product(s) related to access and reimbursement.
• Maintain a deep understanding of NPC policies and requirements and perform all responsibilities with integrity and consistency with company guidance and prescribed Values and Behaviors. Handle Patient Identifiable Information (PII) appropriately in compliance with HIPAA and other privacy laws and regulations.
• Responsible for identifying and reporting adverse events via the established Novartis systems as per applicable processes.

• Assess access situation within…