Access & Reimbursement Manager; ARM - Renal - Minneapolis; Remote

Role 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 strategy. The ARM serves as 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 account workflows.

This role requires problem solving and proactive communication of changes in the healthcare landscape, with cross-functional collaboration across NPC teams.

• 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) to support patient access to products.
• Analyze problems and offer solutions related to payer policies (utilization management, denial and appeals), drug acquisition and inventory management, and patient/practice reimbursement; identify trends and partner to support patient pull-through.
• Support pull-through on local coverage decisions to enable meaningful patient access; proactively communicate policy changes or issues that could affect other departments.
• Stand up NVS-sponsored patient support programs to enable patients starting and staying on therapy (e.g., Co-pay).
• Maintain expertise in regional and local access landscape and act as the aligned product reimbursement expert as needed.
• Interface with Patient Support Center (hub) on patient case management, tracking cases, resolution, reimbursement support, and staff education; review patient-specific information as requested.
• Collaborate with cross-functional NPC associates to share insights on customer needs and barriers related to access and reimbursement.
• Maintain understanding of NPC policies and ensure HIPAA/privacy compliance; handle PII appropriately.
• Identify and report adverse events via established Novartis systems as per applicable processes.

• Required: Bachelor’s degree; minimum 3–5 years' experience in public or private third-party reimbursement or pharmaceutical industry in managed care, clinical support, or sales; specialty pharmacy experience; experience with coding, billing, and in-office support programs; prior account management experience with complex accounts; ability to travel 50%+ and cover large multistate geography; valid driver’s license.
• Required: Knowledge of CMS policies and processes (Medicare Parts B and
  
  D) a plus; knowledge of Managed Care, Government and Federal payer sectors, and IDNs a plus; ability to collaborate across sales and internal teams to reach goals.
• Required: Ability to operate as a team player and travel; driving is an essential function of the role with a fully valid/unrestricted driver's license required.
• Required: Ability to manage reimbursement barriers for patients in specialty products and establish relationships within practices to support access.

• Bachelor’s Degree required; advanced degree preferred.

• Desirable: ability to manage multiple products; excellent presentation skills; advanced knowledge of medical insurance terminology; strong teamwork; project management skills; ability to work independently; ability to manage expenses within budgets; good driving record; ability to schedule travel; proficiency with PowerPoint, Excel, Word, CRM (Salesforce).
• Desirable: understanding of patient privacy laws including HIPAA and related state laws; strong business acumen; willingness to travel and maintain valid driver’s license.