Specialty Access & Reimbursement Manager (Western, NY)

Job Description:

Specialty Access & Reimbursement Manager (SARM)

Individuals successful in this role possess a strong passion for patient access and thrive in a highly complex environment. The ability to problem solve and collaborate effectively is a critical skill set for GSK ARMs. This role requires exemplary customer engagement skills, a penchant for business ownership and the ability to understand nuanced reimbursement and access technical skills.

The responsibilities of the role include but are not limited to the following.

• Supports access to GSK Specialty products for appropriate patients.
• Specialty ARMs are responsible for educating providers on payer coverage, coding and payment policies related to GSK specialty products and helping providers understand GSK Patient Support Programs intended to help appropriate patients access GSK specialty medicines.
• Specialty ARMs routinely interface internally with Payer Account Managers, Specialty Pharmacy Account Directors and Specialty Sales professional teams.
• Qualified candidates must possess a demonstrated track record of success working in a matrix environment and must demonstrate effective leadership skills.

Analyze access/reimbursement issues and opportunities.

• Provide offices product access/reimbursement expertise.
• Provide access/reimbursement education to field teams.
• Coordinate on access/reimbursement issues with third parties including hubs.
• Support patient access to the products by providing subject matter expertise on reimbursement issues that may be barriers to product access.
• This role reports to a Director of Specialty Field Reimbursement.

Basic qualifications:

• Bachelor’s Degree
• Ability to travel up to 60% including overnights
• Must live in or within 10 miles of the territory
• Valid driver’s license
• 3+ years’ experience one or more of the areas including Field Reimbursement or Specialty or Biologics Field Sales (HCP administered or Specialty Pharmacy provided) or Payer Marketing or Patient Support Programs

Preferred qualifications:

• MBA, MPH or other advanced degree
• In larger geographies the candidate should live within 50 miles of a major metropolitan airport.
• 6+ years’ experience one or more of the areas including Field Reimbursement or Specialty or Biologics Field Sales (HCP administered or Specialty Pharmacy provided) or Payer Marketing or Patient Support Programs
• Reimbursement experience for immunology, respiratory, or other specialty injected/infused products in a buy and bill setting across all sites of care.
• Knowledge of the payer environment including state, federal,and private third-party; payer reimbursement methodologies; and payer policies for HCP and self-administered drugs.
• Demonstrated experience in customer focus with building relationships, issue identification and resolution, problem-solving and project management skills.
• Evidence of the ability to operate independently and handle multiple projects with a high degree of initiative. Ability to operate successfully as a leader in a matrix environment without direct reports.
• Organized, strategic thinker with excellent verbal, written and presentation communication skills.
• Knowledge of provider office and hospital outpatient department reimbursement environments, regulations, customers, and account-based planning.
• Knowledge of Specialty Pharmacy access process.
• Comprehensive understanding of Commercial, Medicare Parts A, B, C, D and state Medicaid reimbursement dynamics.
• Understanding of HCPCS, CPT, and ICD-10 coding regulations.
• Experience working with HUB or reimbursement call centers in support of patient access.

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The US annual base salary for new hires in this position ranges from $152,250 to $253,750. The US salary ranges take into account a number of factors including work location within the US market, the candidate’s skills, experience, education level and the market rate for the role. In addition, this position offers an annual bonus and eligibility to participate in our share based long term incentive program which is dependent on the level of the role. Available benefits include health care and other insurance benefits (for employee and family), retirement benefits, paid holidays, vacation, and paid caregiver/parental and medical leave. If salary ranges are not displayed in the job posting for a specific country, the relevant compensation will be discussed during the recruitment process.

Please visit GSK US Benefits Summary to learn more about the comprehensive benefits program GSK offers US employees.

Why GSK?

Uniting science, technology and talent to get ahead of disease together.

GSK is a global biopharma company with a purpose to unite science, technology and talent to get ahead of disease together. We aim to positively impact the health of 2.5 billion people by the end of the decade, as a successful, growing company where people can thrive. We get ahead of disease by preventing and treating it with innovation in specialty medicines and vaccines. We focus on four therapeutic areas: respiratory, immunology and inflammation; oncology; HIV; and infectious diseases – to impact health at scale.

People and patients around the world count on the medicines and vaccines we make, so we’re committed to creating an environment where our people can thrive and focus on what matters most. Our culture of being ambitious for patients, accountable for impact and doing the right thing is the foundation for how, together, we deliver for patients, shareholders and our people.

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GSK is an Equal Opportunity Employer. This ensures that all qualified applicants will receive equal consideration for employment without regard to race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), military service or any basis prohibited under federal, state or local law.

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