Field Reimbursement Manager, Immunology; Eastern

Overview

Company Description

Statistics show that women and underrepresented groups tend to apply to jobs only if they meet 100% of the qualifications. Sobi encourages you to change that statistic and apply. Rarely do candidates meet 100% of the qualifications. We look forward to your application!

At Sobi, each person brings their unique talents to work as a team and make a difference. We are dedicated to developing and delivering innovative therapies to improve the lives of people who live with a rare disease. Our edge comes from our team of people and our commitment to patients. Our Mission And Culture At Sobi North America Get Us Excited To Come To Work Every Day, But Here Are a Few More Reasons To Join Our Team:

• Competitive compensation for your work
• Generous time off policy
• Opportunity to broaden your horizons by attending popular conferences
• Emphasis on work/life balance
• Collaborative and team-oriented environment
• Making a positive impact to help ultra-rare disease patients who are in need of life saving treatments

Sobi is seeking a highly experienced, passionate Field Reimbursement Manager. Reporting to the Director of Field Reimbursement in the Immunology Franchise, the Field Reimbursement Manager (FRM) is an important member of the Sobi Market Access team.

The FRM role is a field-based, non-promotional resource for infusion centers, health systems, institutions, hospitals, and HCP practices/groups that serves as the key to help unlock patient access and resolve reimbursement issues. The successful candidate brings strong knowledge and proven work history of access and reimbursement for buy-and-bill/infused pharmaceutical products. The FRM, in addition to working closely with external customers, will work with numerous internal teams, including Patient Services, Market Access colleagues, Medical Affairs, Advocacy, and Marketing to facilitate and support patient access to treatment.

The FRM is a critical component of customer support and will rely on strong problem-solving skills to provide outstanding customer experiences and outcomes.

• Customer Engagement:
  As a field reimbursement manager, the FRM is expected to maintain a targeted account list of customers and proactively engage accounts live and virtually.
• Proactively and consistently work with assigned customers to educate on access and reimbursement as well as build and maintain relationships with all relevant departments and personnel, including Infusion Center Manager, Biologic Coordinators, Reimbursement Specialist/Coordinator, Patient Access Specialist, Financial Counselors, Billing and Coding Specialists, Nurse Navigator, Pharmacists, Revenue Cycle Manager, Patient Advocates and prior authorization specialists.
• Acting as the subject matter expert with a deep level of understanding of buy and bill reimbursement and access & reimbursement across all channels (Commercial, Medicare, Medicaid, Government) who educates and identifies compliant solutions to overcome patient access and reimbursement issues.
• Providing proactive education to prescribers and sites of care upon patient enrollment on coverage for Sobi therapies, common prior authorization requirements, and coding and billing requirements.
• Providing comprehensive education to healthcare providers and their staff on reimbursement procedures, coding, billing, and documentation practices specific to biologic therapies.
• Educating infusion centers, HCP offices, health systems, institutions, and hospitals, in understanding the mechanics of patient benefit verification, product ordering through Specialty Pharmacy, Specialty Distribution.
• Demonstrated ability to investigate access challenges pre and post-infusion for Sobi products
• Assist healthcare providers in understanding and managing reimbursement processes for buy-and-bill infused biologic products, including compliant support on prior authorizations, appeals, and denials.
• Assisting infusion centers, HCP offices, health systems, institutions, and hospitals, in understanding billing & coding; specifically CPT coding, J-Codes and modifiers as well as use of CMS 1500 and UB-04 forms.
• Acting as a bridge between the customer, the patient services team, and Sobi sales and account management team to address access escalations and payer access issues.
• Working closely with the HUB and the Case Managers to compliantly address escalations and access issues for HUB patients.
• Working with local Sobi colleagues with a high level of cross-functional support for accounts in a defined geography.
• Additional responsibilities include developing local solutions through account and market insight and providing Sobi leadership with market intelligence. This role inspires solution-oriented passion across cross-functional teams.

• Demonstrates deep knowledge in:
  Reimbursement experience supporting infused product – Buy and Bill;
  Reimbursement and access across all channels (Commercial, Medicare, Medicaid, Exchange and Government) and is the…