Associate Director, Systems Access and Reimbursement- Remote Indiana

Dec 09, 2021

Job Description

Job Purpose

1.4 million patients are projected to be supported by Novartis Patient Specialty Services (PSS) by 2023. Importantly, PSS is increasingly providing strategic leadership, execution and resources to help appropriate patients access, initiate and remain on the Novartis medications needed to improve their lives. Today a significant percentage of patients are unable to access appropriate treatments and are lost before their first prescription is filled, with a majority lost at year one. Losing a majority of patients for preventable reasons is unacceptable and we know patients deserve better.

The Associate Director, Systems Access & Reimbursement (ADSAR) for Cardiovascular Renal Metabolism (CRM) is responsible for ‘access’ to product with in the assigned geography, where ‘access’ means the product is available for use within the assigned systems of care (SOCs), affiliated organizations and other appropriate organizations. Product access may be achieved via central procurement or through alternate sites of care, or at the individual facility level via the facility’s preferred process.

The ADSAR (CRM) proactively assesses system/organization capabilities regarding product procurement, product billing and internal communication vehicles and provides education and support on product access programs for appropriate system or organization staff. The ADSAR will educate and support the integration of product into SOCs and/or other appropriate entities, as well as provide support to the SOC and/or other appropriate entities on reimbursement related processes and issues, as needed. Additionally, the ADSAR will maintain geographic access expertise and overlay payer policy for proactive identification of access issues/opportunities; acting as the regional and local resource for Novartis Payer team, field reimbursement managers, sales force personnel and region management. The ADSAR will need to coordinate cross functionally, as needed, within Novartis Pharmaceuticals Corporation (NPC) (i.e. System Executive Team (SET), Field Reimbursement Director, Payer teams, Field Reimbursement Manager, Field Sales, Market Access Marketing, Public Affairs, State & Government Affairs, Trade, Specialty Pharmacy Account Management and applicable third parties).

Major Accountabilities
• Coordinate with regional SETs to understand SOC key priorities in atherosclerotic cardiovascular disease (ASCVD), financial goals and population health initiatives to influence overall account and regional business strategies.
• Assess access situation within the assigned geography and develop appropriate Plan of Action (POA). Communicate POA to appropriate personnel.
• Assess and understand SOC and/or other appropriate organizations’ level of centralization of Buy & Bill capabilities (procure, inject & bill) to prioritize accounts and identify the need for alternate sites.
• Work closely with regional SET to understand P&T ulary processes so that once clinical decision is made to use product, ADSAR can work with SOC procurement personnel so that SOC facilities and related organizations understand options to acquire product.
• Work with appropriate SOC personnel to validate that access & reimbursement pathways are in place for each major payer within the SOC and assigned geographic region.
• In conjunction with the regional SET, create the initial POA to support access and reimbursement within the SOC and/or geography.
• Develop SOC/geographic specific POA to address Payer issues and coordinate with regional SET, Payer Team and FRDs appropriately, including as part of POA, to identify alternate sites for injection where gaps in procurement exist.
• In coordination with the regional SET educate SOCs and/or other appropriate organizations on NPC policies related to product ordering, payment, inventory, and product returns & replacement.
• Work with key SOC and/or other appropriate organization staff members (i.e., procurement, billing, reimbursement staff) in order to appropriately support patient access to product by providing overview of services available to support patient access (PSS).

Field Coordination and Integration
• Support the iSET model to create POA to support product strategic initiatives that will support process integration to facilitate patient access to therapy in the SOC and/or other appropriate organizations to include product in their systems (e.g. Procurement) and processes (e.g. Formulary)
• Collaborate, communicate and integrate closely with Regional Directors to provide appropriate regional insights and trends to field teams (Field Sales, FRMs, Marketing) as needed to address SOC access and reimbursement issues and support regional and account level strategies.
• Work closely with Payer Teams to fully understand payer policy, regional coverage trends, coding and reimbursement requirements as well as the Service in order to communicate the information to the SOC and/or other appropriate organizations’ billing staff
• Regional point of contact for Service Center and Alternate Injection Center
• Proactively work with the regional SET and internal partners to draft appropriate direction and/or communications for regional Novartis field teams.
• Provide ongoing proactive support and communication to the regional SET to inform on progress on access POA, anticipate issues and communicate proposed resolutions and align access activities with broader regional SET goals/initiatives within the SOC and/or other appropriate organizations.

Ongoing Access and Reimbursement Support
• Maintain expertise in SOC regional and local access landscape, anticipating and planning for changes in the healthcare landscape, and act as the product access and reimbursement expert for the SOCs and/or other appropriate organizations and local field teams (Field Sales and FRMs).
• Apply subject matter expertise to support regional SOCs with complicated access & reimbursement issues.
• Act at the main point of contact for the SOC and other appropriate organizations within the assigned geography regarding impact of payer policies in the region at the point of care.
• Triage to appropriate Novartis personnel to address any customer issues and opportunities as they arise related to payer policies that impact access to patient therapy.
• Support questions associated with specific patient reimbursement

Diversity & Inclusion / EEO

The Novartis Group of Companies are Equal Opportunity Employers and take pride in maintaining a diverse environment. We do not discriminate in recruitment, hiring, training, promotion or other employment practices for reasons of race, color, religion, gender, national origin, age, sexual orientation, gender identity or expression, marital or veteran status, disability, or any other legally protected status. We are committed to building diverse teams, representative of the patients and communities we serve, and we strive to create an inclusive workplace that cultivates bold innovation through collaboration and empowers our people to unleash their full potential.

Minimum Requirements

What you will bring to the role:

• Bachelor’s Degree required. Advanced degree preferred
• 6+ years (pharma or biotechnology) or related healthcare industry
• 5+ years of experience in Access and/or Field Reimbursement Manager; Regional or Corporate Account IDN Management, Hospital Account Management
• Experience in pharmaceutical/biotech reimbursement and/or practice/hospital management support role in a managed markets environment
• Procurement experience (SDs, GPOs, SP), highly preferred
• Strong knowledge of buy-and-bill billing and reimbursement pathway.
• Possess a strong understanding of Commercial payers, Medicare B and D plans and state Medicaid in assigned geographic region.
• Experience in patient assistance support (i.e. Copays programs

Preferred Qualifications:
• Experience leading and delivering presentations to C-level account executives.
• Strong ability to work cross functionally with such functions as Field Sales, Marketing, Market Access (Payer teams), Public Affairs, State & Government Affairs, Trade, Specialty Pharmacy Account Management and applicable third-party affiliates.
• Ability to coordinate/manage large project.
• Expertise in SOC dynamics and common access, reimbursement and product program support-related needs.
• Strong capabilities in the areas of technical and business expertise, achieving results, customer focus, teamwork and collaboration, business acumen, and communication.

What you’ll receive:
Competitive salary, annual bonus, long term incentive for select levels, health insurance, paid vacation/holidays, potential flexible working arrangements, employee recognition program, employee referral program

Why consider Novartis?
769 million. That’s how many lives our products touch. And while we’re proud of that fact, in this world of digital and technological transformation, we must also ask ourselves this: how can we continue to improve and extend even more people’s lives?

We believe the answers are found when curious, courageous and collaborative people like you are brought together in an inspiring environment. Where you’re given opportunities to explore the power of digital and data. Where you’re empowered to risk failure by taking smart risks, and where you’re surrounded by people who share your determination to tackle the world’s toughest medical challenges.

Commitment to Diversity & Inclusion:
Novartis embraces diversity, equal opportunity and inclusion. We are committed to building diverse teams, representative of the patients and communities we serve, and we strive to create an inclusive workplace that cultivates bold innovation through collaboration, and
empowers our people to unleash their full potential.

Join our Novartis Network: If this role is not suitable to your experience or career goals but you wish to stay connected to learn more about Novartis and our career opportunities, join the Novartis Network here:
We are Novartis. Join us and help us re-imagine medicine.

Accessibility and reasonable accommodations
The Novartis Group of Companies are committed to working with and providing reasonable accommodation to individuals with disabilities. If, because of a medical condition or disability, you need a reasonable accommodation for any part of the application process, or in order to perform the essential functions of a position, please send an e-mail to [email protected] call +1 (877)395-2339 and let us know the nature of your request and your contact information. Please include the job requisition number in your message.
Indianapolis, IN
Market Access
Full Time
careers default image

Associate Director, Systems Access and Reimbursement- Remote Indiana

Apply to Job Access Job Account