- Serve as a liaison to all engaged sites of care administering UCB rare disease product(s) through a patient's medical benefit and pharmacy benefit.
- Provide support to patients and accounts specific to benefit verifications, product procurement processes, reimbursement information, billing, coding, and coverage details.
- Provide on-demand education, including Lunch and Learns or Dinner presentations, for office staff regarding Reimbursement and support services.
- Advises all sites of care on payer specific nuances related to utilization management protocols, appeals processes and the year -end re-authorization verification process.
- Work with all engaged sites of care to inform them on matters related to access and reimbursement of UCB rare disease products.
- Sole point of contact for all stakeholders should a Medical Claim denial be presented by a provider.
- Develop strategic coverage, access and reimbursement relationships with their local Medicare Part A/B Contractors and attends Medicare Part A/B Contractor open meetings.
- Provide coverage updates, policy changes and communications to internal UCB colleagues.
- Provide strategic coverage and reimbursement, benefit recertification support and marketplace feedback to internal colleagues aligned to their geographies.
- Bachelor's degree required (Master's preferred)
- 2+ years' Reimbursement/Account Management experience preferred
- 8+ years of pharmaceutical or biotech experience
- Excellent working knowledge of evolving reimbursement landscape and the practice management environment
- Neurology, Rare Disease or buy and bill experience a plus
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Rare Reimbursement Executive, Pacific Northwest - Atlanta, United States - UCB
Description
Make your mark for patients
We are looking for a Rare Reimbursement Executive, Pacific Northwest who is self-aware, patient centric and collaborative to join us in our Market Access and Affordability Team.
This is a field-based position that requires up to 75% daily and overnight travel will cover Northern California, Northern Nevada, Colorado, Idaho, Utah, Washington, Oregon and Montana and is designed to support the Pacific Standard and Mountain Standard Timezones.
About the RoleYou will ensure that appropriate patients have access to UCB rare disease products and Patient Services.
You will also provide ethical commentary on local, regional, and national payer coverage and their pharmacy and medical policies to all engaged sites of care.
You will leverage your knowledge in the market access and reimbursement journey encompassing procurement, payer policies and coverage, benefit design, prior authorizations, appeals, exceptions, denials, coding and payer payment guidelines, site of care regulation/requirements, understanding of coding guidelines with demonstrated knowledge of the complex payer environment.
You will relay detailed benefit information in order to maximize the Provider and Staff experience including market dynamics, coverage, billing, coding and reimbursement policies for all sites of care involved.
Who you'll work withInternally, you will work with stakeholders across Market Access, Sales, the Patient Assistance Program, Marketing and Compliance. Externally, you will work with sites of care, patients and their respective payer, specialty pharmacies and pharmacy benefit managers.
What you'll do
Internal applicants should be in their current job for at least 12 months, must meet performance standards and are not on formal corrective/disciplinary process (PIP), warning, final warning, or compliance warning letters within the last 12 months.
As an Equal Opportunity Employer, we are open to all talent, and adhere to Affirmative Action principles.
This ensures that all qualified applicants will receive equal consideration for employment without regard to neurodiversity, race/ethnicity, colour, national origin, religion, gender, pregnancy, marital status, sexual orientation, gender identity/expression, age, disability, genetic information, military service, covered/protected veteran status or any other federal, state or local protected class.
Should you require any adjustments to our process to assist you in demonstrating your strengths and capabilities contact us on US- for application to US based roles.
Please note should your enquiry not relate to adjustments; we will not be able to support you through this channel.
Requisition ID: 86971Recruiter:
Parth Suthar
Hiring Manager:
Robert Ryan Buehler
Talent Partner:
Mauricio Miranda
Job Level:
MM II - MM I
Please consult HRAnswers for more information on job levels.
