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

Summary

The Associate Director, Access & Reimbursement (ADAR) is a field‑based role covering the Thousand Oaks, Bakersfield, Oxnard, and Lancaster areas in California. The associate must reside within the territory or be within 60 miles commuting distance.

The ADAR proactively provides in‑person (or virtual as needed) education on access and reimbursement topics to accounts within assigned geographies.

• Interact with large, complex accounts to support patient access within the aligned therapeutic area product(s), proactively providing face‑to‑face education on programs to providers and staff to support product integration into office processes and workflows.
• Work with key members of therapeutic area offices (executives, providers, administrators, billing and coding staff, claims departments, revenue cycle managers) to appropriately support patient access to products.
• Analyze problems and offer solutions. Understand specifics and support questions related to patient reimbursement, provide assistance on reimbursement issues with third‑party payers at the provider level, and analyze account reimbursement issues as needed.
• Support pull‑through on local coverage decisions to enable meaningful patient access within the system, proactively communicating policy changes or issues that could affect other departments.
• Maintain expertise in the regional and local access landscape, anticipating changes in the healthcare landscape, and act as the aligned therapeutic area product(s) reimbursement expert as needed.
• Interface with Patient Support Center (hub) and Access & Reimbursement Managers on matters related to patient case management, including tracking cases, issue resolution, reimbursement support, and office staff education.
• Collaborate with aligned cross‑functional associates within NPC to share insights on customer needs and barriers for access and reimbursement.
• Educate HCPs using approved materials regarding acquisition pathways for Novartis products, including buy‑and‑bill end‑to‑end processes, workflows, and facility pull‑through in complex accounts with scenarios of centralized and decentralized acquisition. Also cover alternative channels such as white bagging, clear bagging, brown bagging, and alternate sites of care for administration.

• Assess the access situation within the assigned geography and develop an appropriate Plan of Action (POA); communicate the POA to appropriate personnel.
• Educate HCPs using approved materials regarding acquisition pathways for Novartis products, including buy‑and‑bill end‑to‑end processes and facility pull‑through in complex accounts.
• Educate relevant stakeholders on logistics related to ordering, payment, inventory, and product returns and 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 regarding Novartis medicines, including pharmacy, system leadership, financial counselors, office administrators, and revenue cycle managers.

• Bachelor’s Degree required; business and/or biological science education preferred; advanced degree preferred.
• 5+ years of experience in the pharmaceuticals/biotech industry focused on patient services, market access, sales, and/or account management. At least 2 years in a patient services practice‑support role for a specialty product.
• Experience working with highly complex practices and/or health systems to establish access and acquisition pathways.
• Strategic account management experience with a proactive approach to anticipate access hurdles impacting accounts and patient access.
• Deep expertise and…